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Metakognitive Terapi (MKT) (BAGGRUND (tredjebølge terapi, stammer fra KAT,…
Metakognitive Terapi (MKT)
BAGGRUND
tredjebølge terapi
stammer fra KAT
mindst buddhisme-inspireret
bakket op af videnskabelige undersøgelser
The approach is based on a specific information processing theory proposed by Wells and Matthews (1994), initially used to treat Generalised Anxiety and subsequently expanded as a general treatment approach
CENTRALE BEGREBER
kognitivt opmærksomhedssyndrom (CAS - cognitive attentional syndrome)
årsagen til alle psykiske lidelser
består af
tidskrævende bekymringer, spekulationer og grublerier (worry/rumination)
fiksering af opmærskomhed på trusler (threat monitoring)
fejlslåen coping-adfærd, der giver bagslag og forværre problemerne
One of the features of psychological disorders such as anxiety or depression is that thinking becomes difficult to control and biased in particular ways that lead to a worsening and maintenance of emotional suffering. Many patients report that they feel that they have lost control over their thoughts and behaviours. Another important feature is that the persons thinking and attention becomes fixed in patterns of brooding and dwelling on the self and threatening information. Metacognitive therapy recognises this change in thinking patterns and believes it is very important. It gives it a name: the Cognitive-Attentional Syndrome (CAS).
This pattern consists of worry, rumination, fixation of attention on threat, and coping behaviours that the person believes are helpful but many of which backfire and keep emotional problems going. The CAS is controlled by metacognitions and it is necessary to remove the CAS by helping patients develop new ways of controlling their attention, new ways of relating to negative thoughts and beliefs, and by modifying metacognitive beliefs that give rise to unhelpful thinking patterns
metakognitioner
programmer i hjernen om hvordan den skal bearbejde information
tanker om tankerne
aspect of cognition that controls mental processes and thinking
For instance, when unable to remember a name a person may feel sure that the name is stored in memory.
Although we are aware of some metacognition operating like in this example, most of the metacognitions that control our thinking and conscious experience operate in the background.
TERAPEUTENS ROLLE/OPGAVE
fjerne CAS ved at hjælpe klilenten til at udvikle nye måder at kontrollere deres opmærksomhed på; nye måder at forholde sig til sine negative tanker på; ved at ændre de metakognitive overbevisninger (tanker om tankerne), der giver andledning til de uheldige tankemønstre og opmærksomhedsmønstre
terapeuten prøver gennem samtale at afdække klientens metakognitive overbevisninger, oplevelser og strategier
introducere konkrete teknikker og strategier
Attentional Training Technique and Detached Mindfulness (this is a distinct strategy from various other forms of 'mindfulness techniques')
lave experimenter sammen med klienten, som udfordrer de metakognitive overbevisninger (e.g. "You believe that if you worry too much you will go 'mad' – let's try worrying as much as possible for the next 5 minutes and see if there is any effect")
KLIENTGRUPPER
der findes manualer til
depression
social angst
OCD
GAD
PTSD
borderline personlighedsforstyrrelser
psykoser
TERAPI
8-12 sessioner
mål
afdække metakognitive overbevisninger (=afdække hvilke overbevisninger klienterne har om deres tanker) og hvordan deres sind fungerer
Vise klienten, hvirdan disse overbevisninger kan lede til uhænsigtsmæssige reaktioner til tanker, hvilke forlænger eller forværrer symptomer.
at give klienten alternative måder at respondere til disse tanker og derved opnå en reduktion i symptomerne
CBT VS. MKT
i CBT er der fokus på neg. aut. tanker, hvorimod der foksueres på metakognitive tanker/processer i MKT
A key difference between MCT and CBT, behavior therapy and is the lack of focus on the content of thoughts and beliefs. In CBT the therapist is concerned with the content of automatic thoughts and invites the patient to reality test this content. In MCT, disorder is viewed as a function not of cognitive content but of processes such as perservative thinking, attentional focus and internal control strategies that are counterproductive.
does not focus on content and does not reality test them