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Detached Mindfulness In Cognitive Therapy: A Metacognitive Analysis And Ten Techniques

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Abstract

This paper describes the nature and information processing requirements of detached mindfulness. The construct emerged from the self-regulatory information processing theory of emotional disorder (Wells & Matthews, 1994), and is viewed as a metacognitive state that facilitates change in core underlying pathological processes. Detached mindfulness has multiple components, requiring the activation of metacognitive knowledge, metacognitive monitoring and control, suspension of conceptual processing, attentional flexibility, and a de-centered relationship with thoughts. A model of the cognitive structures and processes supporting the state is presented. Implications of the model for the scientific development and effective use of mindfulness techniques are discussed. Ten techniques for rapidly achieving detached mindfulness in the course of metacognitive therapy are described.

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... For example, (If I have thoughts of harming myself, I will end up causing it), (If I think I am in danger, then that means I am really in danger). These beliefs are implicit manifestations of the sincerity of authoritarian intellectual mental experience, and people with disturbances essentially act as if these ideas were correct (Adrian Wells, 2005;A. Wells et al., 2001). ...
... The five-factor model is consistent with the original FFMQ, and confirmed that the FFMQ is the most appropriate for this study. Nevertheless, the results of the current study differed from the findings of Baer (2007), as the CFA results showed that there are four facets that appeared as clear indicators of the structure of mindfulness except (observation), and they agreed with the results of Radoń (2014); Adrian Wells (2005), which supported the results of the CFA as a four-factor model without observation. The results of the present study are also inconsistent with those of Pang and Ruch (2019), which supported the results of the CFA as a three-factor model consisting of observation, description, and non-judgment, as supported by the study of Chadwick et al. (2008) which suggested that it had two factors: present awareness and acceptance. ...
... As for the correlation of mindfulness with thought fusion beliefs, the results of the current study concluded that the facets of acting with awareness and non-judgment correlated negatively with thought fusion beliefs; the facets of observation and description positively correlated with thought fusion beliefs in its three dimensions; and the facet of non-reactivity did not correlate with thought fusion beliefs (See table 5). This result is explained in the light of what Adrian Wells (2005) mentioned regarding the Cognitive Attention Syndrome (CAS), which he described as excessive self-focus, repetitive negative thinking, and an increased focus on threat. Adrian Wells (2005) sees the primary goal of metacognitive therapy as promoting detached mindfulness, which he defined as the objective awareness of inner thoughts and events in the absence of conceptual analysis. ...
Article
Mindfulness includes individuals' opinions, feelings, and objective observations. The present study aimed at examining the factor structure and reliability of the Five-Facet Mindfulness Questionnaire for the Egyptian culture and investigating the relationship between mindfulness and thought fusion beliefs. This descriptive, cross-sectional and psychometric study was conducted on 507 university students (241 males, 266 females) from Assuit City, Egypt, selected using the available sampling method in 2018. The Principal Axis Factoring Approach to Exploratory Factor Analysis (EFA), the confirmatory factor analysis, concurrent validity and the relationship between mindfulness and depression were conducted to examine the validity of the Five-Facet Mindfulness Questionnaire. Criterion validity was verified using correlations with BDI-II, TF, SA, CERS and CSC to calculate the reliability and validity of the Five-Facet Mindfulness Questionnaire. Cronbach’s alpha and Composite reliability were employed. Statistical analysis was performed with SPSS version 23 and LISREL 8.8. The results of the EFA suggested five factors for this scale labelled as “observing” “describing” “acting with awareness” “non-judging of inner experience” and “non-reactivity to inner experience”. The reliability of this scale was good, and the correlation between mindfulness and depression was negative and significant in the following two facets: (acting with awareness, non-judging of inner experience). The results of the study also showed that the dimensions of observation and description were positively correlated with thought fusion beliefs, while the dimensions of non-judgment and acting with awareness were negatively associated with thought fusion beliefs.
... To be in balance, I don't even remember what that is anymore." Important to the interpretation of these findings may be the metacognitive theory of detached mindfulness (Wells, 2005), which considers athletes' awareness of their own thoughts and beliefs about the stressful situations and their attempts to react by acceptance or suppression. According to the detached mindfulness framework, athletes exhibited facilitative reactions to stress likely due to their ability to detach their attention from potential stressors and to avoid dwelling on dysfunctional thoughts and preservative cognitions (worries and ruminations), in relation to the stressor. ...
... Athletes in this group seemed to focus considerable attention and cognitive processing on attempting to manage and solve the stressors they faced. As the results show, athletes' abilities to consciously decide on how they react to a stressful situation may be crucial in giving (dys-)functional thoughts their salience, and to determine the outcome of the stress response (Wells, 2005). ...
... Such interventions may be especially useful for junior athletes, as juniors have lower ability to cope with adversity than senior athletes (Bebetsos and Antoniou, 2003). Relevant interventions may be built on the cognitive-behavioral approach, utilizing, for instance, aspects of the metacognitive theory of detached mindfulness, in order to increase awareness of own thoughts and beliefs about stressful situations, and to encourage attempts to react to stressors by acceptance rather than suppression (Wells, 2005). Previous research has shown that group, school-based programs developed to increase mental resilience in adolescents lead to reduction in depressive symptoms (Brunwasser et al., 2009). ...
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On their journeys toward senior athletic status, junior endurance athletes are faced with a multitude of stressors. How athletes react to stressors plays a vital part in effective adaptation to the demanding, ever-changing athletic environment. Sleep, the most valued recovery strategy available to athletes, has the potential to influence and balance athletic stress, and enable optimal functioning. However, sleep is sensitive to disturbances by stress, which is described by the concept of sleep reactivity. Among athletes, poor sleep quality is frequently reported, but our understanding of the associations between stress and sleep in junior athletes is currently incomplete. The present study therefore investigated the themes of stress and sleep, and the associations between these variables with the use of in-depth semi-structured interviews in six junior endurance athletes (three men and three women, mean age 17.7 ± 0.5 years). Data was analyzed qualitatively based on the Grounded Theory. The qualitative material was supplemented with quantitative data on subjective sleep quality (Pittsburg Sleep Quality Index), sleep reactivity (Ford Insomnia Response to Stress Test), and mental strain (visual analog scale). The main results showed that stress could be differentiated into relevant stressors (encompassing poor performance, uncertainty in relation to training, school, daily hassles, and sleep) and reactions to stress (with sub-categories facilitative and maladaptive). Sleep could be differentiated into sleep benefits (encompassing energy levels and athletic functioning) and sleep quality (with sub-categories satisfactory and inadequate). All athletes identified relevant stressors, and all athletes were aware of the benefits of sleep for athletic functioning. However, athletes formed two distinctive categories based on the interactions between stress and sleep: three exhibited facilitative reactions to stress and good sleep quality, as well as low sleep reactivity, and low mental strain. The remaining participants exhibited maladaptive reactions to stress and poor sleep quality, as well as high sleep reactivity and high mental strain. Conceptualizing sleep quality based on the evaluation of stressors, reactions to stress, degree of mental strain, and the propensity to stress-related sleep disturbance may offer a plausible explanation for why the occurrence of stressors leads to poor sleep quality in some athletes, but not others.
... Information that an individual holds regarding their own internal states and cognitions is defined as 'metacognition' (Wells, 2000). Over the past 30 years, there has been a large increase in the literature investigating the role of metacognition in psychological disorders (Wells, 2013). ...
... Coping via ruminative thinking, thus avoiding active problem-solving, means that self-critical cognitions go unchallenged. Consequently, the acquisition of new and effective skills are obstructed (Wells, 2000). This has been shown using experimental studies that have induced rumination in individuals experiencing distress. ...
... By identifying the metacognitions that maintain the CAS, the individual can learn to alter these and acquire novel ways in which to respond to negative intrusive thoughts. Some of the practices used in MCT include the attention training technique (Fergus & Bardeen, 2016;Fergus et al., 2014;Knowles et al., 2016), detached mindfulness (Gkika & Wells, 2015;Wells, 2005), worry mismatch and rumination postponement (Wells, 2013). These all work towards increasing the flexibility of how one responds when experiencing unhelpful cognitions. ...
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Past research has shown that perfectionism, can negatively impact self-esteem. However, the mediating factors that explain this relationship remain unclear. The current study aimed to investigate whether specific cognitive processes, namely, self-critical rumination and associated metacognitions, mediate this relationship. An opportunity sample of 347 participants completed a battery of online questionnaires measuring clinical perfectionism, self-critical rumination, metacognitions about self-critical rumination, self-esteem, and levels of psychological distress. Several hypotheses were tested to examine the associations between the study variables. Following this, a path analysis was used to determine whether the influence of perfectionistic concerns and perfectionistic striving on self-esteem is mediated by positive metacognitions about self-critical rumination, self-critical rumination, and negative metacognitions about self-critical rumination, serially. Positive metacognitions about self-critical rumination, self-critical rumination, and negative metacognitions about self-critical rumination partially mediated the relationship between perfectionistic concerns and self-esteem and fully mediated the relationship between perfectionistic striving and self-esteem. These results point towards possible interventions for those who struggle with low self-esteem due to their perfectionistic tendencies. Further investigations should explore additional factors that help to explain why perfectionism impacts self-esteem levels, whilst also addressing the limitations of this current research.
... MF iki temel bileşenden ibarettir: (a)Yargısız farkındalık (mindfulness) ve (b) ayrışma ve mesafe koyma (detachment). Buradaki farkındalık sadece zihinsel süreçlerdeki akışın farkında olmayı kast etmekteyken ayrılma ve mesafe koyma zihindeki kavramsal işleme süreci veya zihinsel baş etme yollarından tamamen ayrışmaya ve bilişlerden kendiliği ayırt edebilme becerisine karşılık gelir (Batmaz, 2014;2015;Fisher ve Wells, 2009;Wells, 2005;2009;. ...
... Sıklıkla bu yeni ilişki kurma tarzı bu yaşantılara herhangi bir şey yapmamayı, sadece onları fark edip gözlemlemekle yetinmeyi, zaman içerisinde de bu kolaylıkla uygulanabilir bir beceri hâline geldiğinde de sorunu büyütüp uzatan tüm eski ilişki kurma tarzlarından tamamen vazgeçmeyi ifade etmektedir. MF uygulamaları sayesinde kişide metakognitif farkındalık düzeyinde artış, hastanın bilişleri içerisinde onlara kaynaşmış hâlde kalma durumundan çıkış, kendiliği bilişlerden ayrı görebilme, içsel yaşantılarla kurulan ilişkide kişisel tercihin etkili olmasının anlaşılması ve dolayısıyla da bunların kişinin kontrolünün dışında olmadıkları inancında pekişme gerçekleşmektedir (Wells, 2005;2009;. ...
... Örnek olarak metakognitif rehberlik, serbest çağrışım deneyi, kafesteki kaplan imgelemesi, düşünceleri bastırma ve bastırmadan kaçınma egzersizleri, "perona yanaşan tren, markette yaramazlık yapan ve istediğini aldırmak için tutturan çocuk, görüşme sırasında çalan ve istenmeyen bir pazarlamacıdan gelen telefon ve yara iyileşmesi" metaforları verilebilir. Bütün bu MF uygulamalarına burada yer vermek mümkün olmadığından daha detaylı bilgi edinmek isteyen okurların ilgili metinlere başvurması önerilir (Wells, 2005;2009). Ancak MF'nin daha iyi anlaşılabilmesi için burada sıralanan örneklerden iki adeti özetlenecektir. ...
... Attention Training Technique (ATT) is a brief (approximately 12 min long) auditory therapeutic technique developed by Adrian Wells (2005), mostly used in Metacognitive Therapy (MCT) for emotional disorders (Wells, 2009). The technique was developed as part of MCT treatment (Wells, 1990), however it is also practiced on its own. ...
... Such beliefs include paradoxically contradictory positive ("Worrying will help me prepare") and negative ("Excessive worrying will make me sick") ones. Therefore, MCT, including ATT, has two main goals: (1) modify maladaptive metacognitive beliefs and (2) diminish CAS (Wells, 2005(Wells, , 2009). These goals are achieved primarily by eliciting a state of detached mindfulness, which consists of flexibly allocating attention at will, consciousness and monitoring of thoughts, conceptualizing thoughts as cognitive phenomena rather than real-life events, low-level analytical and meaning-based appraisals, and reducing efforts to remove or avoid threats (Wells, 2005). ...
... Therefore, MCT, including ATT, has two main goals: (1) modify maladaptive metacognitive beliefs and (2) diminish CAS (Wells, 2005(Wells, , 2009). These goals are achieved primarily by eliciting a state of detached mindfulness, which consists of flexibly allocating attention at will, consciousness and monitoring of thoughts, conceptualizing thoughts as cognitive phenomena rather than real-life events, low-level analytical and meaning-based appraisals, and reducing efforts to remove or avoid threats (Wells, 2005). ...
Article
Objective Attention Training Technique (ATT) is a key therapeutic tool in metacognitive therapy. There are numerous studies on the behavioral effects of ATT, however the neural mechanisms at work in the training are yet to be uncovered. To date there have been no controlled fMRI studies of ATT. Method We conducted a randomized double-blind controlled study of two groups with varying levels of cognitive-attentional syndrome (CAS). Groups with high (n = 43) and low (n = 46) levels of CAS underwent a single session of ATT or a control condition (CON) in an MRI scanner. Participants underwent resting state functional MRI (rsfMRI) sessions and rumination induction sessions both pre- and post-intervention Functional connectivity analyses and inter-subject correlations analyses were computed. We also collected data on emotion and attention functioning pre- and post-intervention. Results We did not observe any behavioral effects of ATT. However, direct comparison between ATT and CON sessions revealed greater inter-subject correlations in almost all hubs belonging to the studied functional networks. Moreover, subjects who received ATT showed diminished connectivity in the fronto-parietal network during ruminations and diminished connectivity of the precuneus with lateral occipital cortices and the intraparietal sulcus in abstract thinking and rsfMRI, respectively. Furthermore, some of the observed effects in functional connectivity and inter-subject correlations were specific to different levels of CAS. Conclusions Our results may support a proposed neural mechanism for ATT: disengagement of attention from CAS-type processing in either low- or high-CAS individuals. It is also possible that some neural effects of ATT are specific to individuals with different levels of CAS.
... Metacognitions are one of the basic processes of the attention model, and effective therapeutic methods may be presented through the metacognitive model to frame what mindfulness is and how it evolves from a conceptual perspective to a practical reality. More specifically, the metacognitive paradigm is correlated with a pattern of responses to ideas that sustain attention to non-adaptive responses and self-threatening thoughts (Wells 2005;Mathers and Loncar 2006). Mindfulness is correlated with dispersion, which is also called hidden cognitive construction and is also correlated with aspects of cognitive attention symptoms, such as extended thinking and ruminations, and thereby reduces the possibility of flexible attention Matthews 1994, 1996;Solem et al. 2015). ...
... It is necessary to stop the autopilot mode because the immediate moment may be biased towards the daily routine and habitual thoughts and feelings, while practicing true mindfulness will make an individual remember the current moment as a direct experience of the body and the sensations it feels (Cash and Whittingham 2010). Mindfulness also involves evoking current emotions and experiences; meditation is therefore a means of developing mindfulness or its related methods of access, and emotional disturbances may thus be explained by a lack of mindfulness skills (Wells 2005;Segal et al. 2013;Van Dam et al. 2012). ...
... The challenges of poor mindfulness correlated with metacognitions arise from the inability to discipline, control, disturbed and ruminate, as opposed to seeking new ways of cognitions that improve the ability to choose flexibility and control. The metacognitions and awareness regulate the activity of the degree of symptoms of cognitive structures or their equivalents, which is itself the so-called separate mindfulness (Solem 2017;Wells 2005). ...
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The current study aimed to test how metacognition relates to the concept of mindfulness attention awareness (MAA), whether metacognitions or MAA best predict symptoms of depression and anxiety, and whether there are significant differences between depression and anxiety levels due to metacognitions and MAA. Data were collected from a public sample through e-mails and social media platforms. The results showed that there was a moderate correlation between MAA and three of the five metacognitive subscales. Both MAA (r = 0.66) and metacognition (r = 0.64) were significantly correlated with depression and anxiety severity scores. Subjects in the depressed group ( r= 0.74) and anxious group (r = -0.47) endorsed metacognitions significantly more, and endorse MAA significantly less than did the nondepressed or nonanxious groups. Additionally, the results of the two-way ANOVA test revealed statistically significant effects for the depression level due to metacognitions (F = 99.802, p= 0.000) and MAA (F = 66.874, p = 0.000) in favor of total scores, as well as for the negative beliefs about the worry, cognitive confidence, and need for control factors. Regarding the level of anxiety, the results revealed significant differences between the anxious and not anxious groups due to the total score of MAA, while there were no differences for the cognitive self-consciousness factor or the overall average score of the metacognitive scale and its five factors upon anxious or not anxious groups. Moreover, the interaction results between depression and anxiety showed that there were significant differences for the negative beliefs about the worry, cognitive confidence, and need for control factors. Finally, regression analyses found metacognition to be an important predictor of symptoms explaining 52% for the depression, and 46% for the anxiety of the variance when controlling for age and gender, while mindfulness was a weaker predictor explaining 3% and 0% respectively of the variance.
... Studies have shown benefits of mindfulness practice (e.g., Mrazek et al., 2012Mrazek et al., , 2013Mrazek et al., , 2016Troy et al., 2013). This involves learning to focus attention (e.g., on one's breath) for extended periods of time but typically also encompasses instructions aimed at changing individuals' attitudes toward the ebb and flow of their thoughts and encouraging thought control strategies (e.g., disengaging) (Wells, 2005). Thus, mindfulness training may implicitly teach a more controllable theory of mind wandering, and reductions in mind wandering may in part be a consequence of this belief change. ...
... Clinical research suggests that a strong belief that one can and must control unwanted thoughts can backfire, because perfect control over unwanted thoughts cannot be achieved. For individuals who demand such control of themselves, failure at controlling all unwanted thoughts can be harshly interpreted as personal failing (Abramowitz et al., 2001;Wells, 2005). While the "controllable" theory of mind wandering does not encompass this imperative that one must control all task-unrelated thoughts, it is possible that a strong "controllable" theory can lead to the perception of personal failing in situations where people are known to mind wander a lot. ...
Article
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People often fail to keep their mind from wandering. Here, we examine how the tendency to mind wander is affected by people’s beliefs, or lay theories. Building on research on lay theories and self-regulation, we test whether differences in people’s beliefs about the extent to which mind wandering is controllable affect thought control strategies and mind-wandering rates in daily life and the laboratory. We develop a new scale to assess control-related beliefs about mind wandering. Scores on the scale predict mind wandering (Study 1) and intrusive thoughts (Study 2) in everyday life, thought control strategies and dysfunctional responses to unwanted thoughts (Study 2), and mind wandering during reading in the laboratory (Studies 3–6). Moreover, experimentally induced lay theories affect mind-wandering rates during reading (Studies 4 and 5). Finally, the effectiveness of strategies people can use to reduce their mind wandering depends on their lay theories (Studies 2 and 6).
... Sessions focused on values clarification (Ciarrochi and Bailey, 2009), worry management, modifying unhelpful beliefs about worry, threat monitoring (unhelpful coping) behaviors, and surveillance/lifestyle education (Butow et al., 2013). Worry management skills included attention training (Wells, 1990), detached mindfulness (Wells, 2005), and worry postponement (Wells, 2008). Experiential exercises and home practice reinforced session content. ...
... Detached Mindfulness teaches participants to reflect on how they think and understand that their thoughts are separate from themselves. Promotes detachment from engagement with troubling thoughts (Wells, 2005) • Worry Postponement Participants are taught to notice thoughts/worries but delay processing them until a designated time during the day. It helps to challenge beliefs that worry is not controllable and promotes disengagement from judgements about worry (Wells, 2008) 5 Introduction to threat monitoring and avoidance. ...
Article
Purpose To assess the feasibility, acceptability, and preliminary effects of a nurse-led intervention for managing fear of cancer progression in advanced cancer patients. Methods A single group mixed methods study was conducted in patients with stage III or IV gynecologic or lung cancer (n = 31) with dysfunctional levels of fear of progression or distress. The intervention consisted of seven videoconferencing sessions with skills practice. Feasibility measures included enrollment rate, attendance, attrition, and home practice adherence. Acceptability was based on exit interview responses. Content analysis was used to analyze the qualitative data. Participants completed quantitative questionnaires assessing fear of progression and secondary outcomes at baseline, eight, and 12 weeks. Linear mixed model analysis was used to assess changes in outcome measures. Results The average enrollment rate was seven participants/month over 4.5 months. Participants attended a mean of 5.3 of seven sessions. Attrition rate was 30%. The analysis showed improvements over time in fear of progression and exploratory outcomes. Participants reported feeling calmer and more focused. The skills practice helped to manage anxiety and fears. Themes included: Struggling with fears, Refocusing the fears, and Realizing/reaffirming what is important in life. The most beneficial components included the values clarification exercise, detached mindfulness and worry postponement practices. Conclusion The intervention was acceptable; most feasibility criteria were met. Preliminary data suggest that the intervention reduced fear of progression and improved secondary outcomes. The intervention required a significant time commitment by participants, which may have contributed to increased attrition. To decrease burden, we will shorten the intervention.
... Detached mindfulness is an adaptive form of self-focused attention. One component of this self-focus-which is defined as objective awareness of thoughts and internal events in the absence of conceptual analysis and goal-directed responses (Wells, 2005)-is attention flexibility. Conversely, a deficit in attention flexibility is shown to be associated with negative rumination (DeJong et al., 2019;Mills et al., 2016;Tortella-Feliu et al., 2014). ...
... However, it is unclear how selection, switching, and divided attention skills contribute to efficacy. While attention regulation ability as a whole is considered to alleviate maladaptive self-focused attention (Wells, 2005), it could play a different role in the relationship between self-preoccupation and depression. Furthermore, because most studies examined state-level effects of brief ATT session, it is unclear whether the efficacy of ATT is due to heightening attentional flexibility or temporally distracting from negative self-focusing. ...
Article
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This study aimed to examine whether attention control skills (selective, switching, and divided attention) moderate the influence of self-preoccupation (the tendency to maintain self-focused attention) on depression. We conducted a cross-sectional survey at a Japanese university. A total of 283 undergraduate and graduate students answered Preoccupation Scale (measuring self-preoccupation), Voluntary Attention Control Scale (measuring self-reported attention control skills), and the Center for Epidemiologic Studies Depression Scale (the standardized measurement of depression), and we analyzed 267 questionnaires (101 men and 166 women). No cut-off points were set for screening individuals depression score. The results of the hierarchical multiple regression analysis were as follows: Higher skills of switching attention were associated with higher depression scores when combined with greater self-preoccupation tendencies. In contrast, higher levels of divided attention skill were associated with lower depression levels when combined with greater self-preoccupation. This study is the first to provide an overview of the protective role of divided attention skill against depression among individuals with high self-preoccupation. We conclude this article by showing that the interventions aiming to increase the divided attention skill rather than switching skill are expected to be effective in decreasing depressive symptoms and discussing the study’s limitations.
... Mindfulness-based Cognitive Therapy is an approach that uses cognitive behavioral therapy (CBT) methods in collaboration with mindfulness meditative practices and similar psychological strategies. Mindfulness-Based Cognitive Therapy (MBCT) was developed based on the metacognitive model (Wells, 2005). Within this metacognitive model, mindfulness is a cognitive state that aids in change by removing, or detaching, thoughts from the negative stimulus (McEvoy et al., 2017). ...
... Interventions (Wells, 2005). Within this metacognitive model, mindfulness is a cognitive state that aids in change by removing, or detaching, thoughts from the negative stimulus (McEvoy et al., 2017). ...
Thesis
Stress within the teaching profession has a negative effect on the health and wellbeing of classroom teachers and on the retention and recruitment on a whole. New teachers are very likely to leave the profession within the first 36 to 60 months of entering the profession. Mindfulness is described as a method of considering one’s position in time amongst many forms of stimulation driving basic thoughts, emotions, and feelings. Through a mindfulness practice, an individual learns how to control their experiences by paying attention to stimuli, in the present moment, and being aware of how that stimulus contributes to an experience (Harrington & Dunne, 2015). The purpose of this systematic literature review was to answer the following research questions: 1) Which approaches, or techniques, are most effective from a macro level in reducing stress in high stress occupations? 2) Why are the selected approaches the most effective in reducing stress? and 3) What would be best-practice recommendations for implementing and evaluating a mindfulness program for classroom teachers? In this systematic review, 34 articles are reviewed. Through the evaluation of findings, recommendations are made on the specific techniques that could be taught as a professional development program for teachers with the goal of reducing job related stress and improving resilience to stressors. These techniques include meditation, breathing, and body scan. To increase successful adoption, the techniques should be taught by an experienced trainer, include a home practice, and be supported with online support and coaching calls. An evaluation plan is also included. Key words: mindfulness interventions, workplace stress, teachers, systematic review
... Detached mindfulness (DM) has multiple components, requiring the activation of metacognitive knowledge, metacognitive monitoring, and control, suspension of conceptual processing, attentional flexibility, and a de-centered relationship with thoughts. The technique is intended to create meta-awareness (e.g., being aware of worry) combined with decentering (Wells 2005). Even though DM involves several components, it could be addressed in therapy using specific exercises (Wells 2005). ...
... The technique is intended to create meta-awareness (e.g., being aware of worry) combined with decentering (Wells 2005). Even though DM involves several components, it could be addressed in therapy using specific exercises (Wells 2005). ...
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Background This study extends previous research by exploring whether changes in obsessive beliefs and metacognitions that were associated with changes in obsessive–compulsive disorder (OCD) symptom severity over the course of group behavioral treatment were maintained at long-term follow-up.Methods Forty patients with a primary diagnosis of OCD participated. The between- and within-person effects were investigated with multilevel longitudinal models. Predictor variables were obsessive beliefs and metacognitions.ResultsAcross the study period, with a mean 8-year follow-up, obsessive and metacognitive beliefs significantly declined. There were significant between-person effects for metacognition and obsessive beliefs on OCD symptom severity. When the overlap between the obsessive belief factors was controlled for, only changes in metacognitions emerged as an independent predictor of OCD symptom severity. A further analysis revealed that metacognitive beliefs regarding the need to control thoughts made a separate contribution at both the between- and within-person levels.Conclusions The results indicate that decreases in metacognitive beliefs during OCD treatment can also have important long-term consequences.
... Another concept which is related to mindfulness and can be effective in social well-being is metacognition. Wells(2005) acknowledged that mindfulness and metacognition are two different programs, but can be considered as overlap approaches in achieving a goal. Both are used to change the client's' thoughts and experiences. ...
... Another skill that overlaps with metacognition strategies is mindfulness. There are a lot of common variables like; self-awareness, self-regulation, selfcontrol, between metacognition and mindfulness that can help them to improve social wellbeing (Wells, 2005). ...
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The aim of the persent study was to investigate the effects of mindfulness and meta-cognitive training on social well-being (SWB) in the among Farhangian University students of Bojnoord. Method: The method was semi-experimental.90 people were selected and randomly from among 540 the employing students by multi stage cluster sampling, then they divided to two experimental groups(60person) and one control group (30 person) randomly. For Measuring SWB, Keyes (1998) the Questionnaire was used. Also, multivariate analysis of covariance (MANCOVA) was employed for data-analysis. results showed that experimental groups outperform control group in pretest in social well-being and all its subscales include acceptance, contribution, integrity, coherence and Social actualization. Conclusion: mindfulness and metacognitive skills training can create positive outcomes in all aspects of student's life especially social life of students. It means that Metacognition and mindfulness are making cognitive and mental changes in individual's life and simultaneously, they improve mindfulness, self-control, responsibility, and supervise student's emotions and empathy.
... The Perspective module primarily targeted socio-cognitive skills such as meta-cognition and perspective-taking on self and others by means of Observing-Thought meditation and a dyadic exercise fostering interpersonal socio-cognitive capacities. Meta-cognition enables observing thoughts as mental events in a dis-identified way (Wells, 2005), and perspective taking further provides the means to detach and deconstruct social schemas to facilitate social interaction (Galinsky et al., 2005). In line with initially hypothesized effects, subsequent ReSource findings showed increased meta awareness of mental content after Perspective training in an acute pre-to post practice comparison (Kok and Singer, 2017b), and likewise increased feelings of social connectedness (Kok and Singer, 2017a). ...
... The Perspective module trained socio-cognitive skills such as perspective taking and meta-cognition through Observing-Thoughts Meditation and a Perspective Dyad. It targets cognitive fluidity by training to adopt a meta-perspective on one's thoughts and detaching or deidentifying with the notions of self and other (Wells, 2005). ...
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Mindfulness-based mental training interventions have become a popular means to alleviate stress and stress-associated health risks. Previous scientific investigations emphasize the importance of exploring the effects of such interventions in naturalistic settings to evaluate their implementation into daily life. Therefore, the current study examined the effects of three distinct mental training modules on a range of measures of daily life experience in the scope of the ReSource Project, a 9-month longitudinal mental training study comparing modules targeting attention and interoception (Presence), socio-affective (Affect) or socio-cognitive abilities (Perspective). We used ecological momentary assessment (EMA) to repeatedly probe levels of stress and stress-coping efficacy combined with stress-reactive cortisol levels, and further explored arousal, affective states, and thought patterns in the daily lives of 289 healthy adults (172 women; 20–55 years). We found increased presence-focused thought and heightened arousal after a training duration of 3-6 months, independent of the type of prior training. Increased coping efficacy emerged specifically after socio-cognitive Perspective training, following 6-9 months of training duration. No training effects were found for subjective stress, stress-reactive cortisol levels, or daily life affect. Our findings corroborate and add ecological validity to previous ReSource findings by showing that they replicate in participants’ everyday environment. Regarding endocrine and subjective stress markers, our results suggest caution in generalizing acute laboratory findings to individuals’ everyday routines. Overall, the current study provides substantiated insights into how cultivating one’s mind through contemplative mental training translates to daily life experience, enhances stress-coping, and may ultimately aide in maintaining health.
... Mindfulness practice provides a sense that there is indeed a path to pursue, and that this path will lead to an end: traditionally, the profound alleviation of suffering, where suffering is not a negative emotion, but a condition of typical human psychology (Kudesia & Nyima, 2015;Purser, 2015). Indeed, numerous scholars have drawn our attention to these metacognitive processes and how they are uniquely enacted within the practice of mindfulness (e.g., Bernstein et al., 2015;Dunne, Thompson, & Schooler, 2019;Jankowski & Holas, 2014;Teasdale, 1999;Wells, 2005). A key takeaway from this research is that very often our unquestioned metacognitive beliefs limit our ability to regulate our attention and process our thoughts and feelings in an adaptive manner. ...
... Metacognitive practice builds on prior work in the mindfulness literature that emphasizes metacognition (e.g., Bernstein et al., 2015;Dunne et al., 2019;Jankowski & Holas, 2014;Teasdale, 1999;Wells, 2005). In particular, it emphasizes the metacognitive beliefs and strategies people use to monitor and adjust their information processing from one situation to the next. ...
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Mindfulness as science has an uneasy relation with mindfulness as practice. Scholars seeking to define mindfulness have typically attempted to turn definitions used by meditation practitioners into scientific constructs-ideally in a manner that honors their Buddhist roots and has relevance for organizations. This produces an abundance of components like present-centered attention, nonjudgment, self-acceptance, etc. that relate to each other only vaguely and point only abstractly to a common idea of mindfulness. Metacognitive practice is an alternative to this multicomponent approach. In it, the role of the scholar is not to select certain practitioner definitions as authentic, relevant, and scientific, but to instead theorize about the attempts practitioners make to define mindfulness. In fact, mindfulness may best be understood as repeated attempts to understand mindfulness. Because organizations are dynamic and complex and expertise is never complete, it is seldom clear what "being mindful" should look like in any specific situation. As such, attempts to understand mindfulness must always continue. People must develop metacognitive beliefs and strategies that allow them to enact mindfulness anew in each situation. Such development of metacognition is not individual: it occurs within a community of practice that furnishes supportive technologies, social interactions, terminologies, and activities.
... ɔ Teaches patients to notice their thoughts and worries but understand that their thoughts are separate from them as a person and not necessarily "truths" in and of themselves; this allows them to view worries as passing events in the mind that do not define or control them, nor are they to be judged or acted on. It is not avoidance, but rather to realize they are just thoughts (Wells, 2005). ɔ There are several exercises from which the patient can choose to use. ...
Article
Background: Fear of cancer recurrence or progression (FOP) is a significant concern for cancer survivors. With the advent of new targeted therapies and immunotherapy, many patients with advanced cancer are living longer while dealing with uncertainty and fears related to cancer progression. Although some level of FOP is normal and adaptive, high levels adversely affect quality of life and healthcare costs. Objectives: This article describes a nurse-led intervention for managing FOP in two patients with advanced gynecologic cancer. The intervention teaches skills for managing worry, challenging unhelpful beliefs, and modifying unhelpful coping behaviors. Methods: Preliminary findings from the two case studies are presented, including a comparison of post-treatment FOP scores to baseline scores. Findings: The participants reported feeling more focused, less overwhelmed, and more in control of their worries. Both participants achieved statistically reliable improvements in FOP scores.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Chapter
A reflective journal, also known as a reflective narrative, is a collection of thoughts, feelings, observations, notes, and other related resources created over a period of time. It typically supplements the study cycle, fieldwork, or a placement experience. The purpose of a reflective journal is to enrich individuals’ learning through the actual process of writing and thinking about their personal experiences. It is a growing document written by the learner to record their learning progress.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Chapter
The focus of this book is on cultivating higher order thinking skills (HOTS) in language classes. It aims to serve as a guidebook for language teachers and students. Although the book is intended to be a practical toolkit for readers, some introductory discussion on HOTS from a theoretical standpoint is helpful in ushering the reader to the practical chapters that follow. Although it might be tempting to leap to HOTS-enhancing techniques and procedures without exploring theoretical standpoints, this may actually result in a superficial and cursory understanding of the following chapters. One of the tenets underlying the present book is that teachers and teacher educators need to realize the significance and rationale of HOTS and become familiar with the different dimensions of HOTS before they can effectively foster these skills in their students.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Chapter
The roots of emotional intelligence (EI) stem from the notion of social intelligence. Thorndike (in Intelligence and its uses. Harper’s Mag 140:227–335, 1920) regarded EI via the lens of social intelligence, stating that social intelligence is the capability to empathize with others and perform sensibly in human relationships (see Goleman in Working with emotional intelligence. Bantam Books, New York, 1998). Nonetheless, his opinions were not greatly welcomed until years later. Emotional thought was viewed to be in the domain of intelligence.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Chapter
Critical discourse analysis (CDA) is the field of study interested in analyzing discourse to find hidden meanings and to uncover the relationships among discourse, ideology, and power (Fairclough in Discourse and social change. Polity Press, Cambridge, 1992). Fairclough (Critical discourse analysis. Longman, London, 1995), the father of modern CDA, defined it as: “The kind of discourse analysis which aims to systematically explore often opaque relationships of causality and determination between (a) discursive practices, events and texts, and (b) wider social and cultural structures, relations and processes; to investigate how such practices, events and texts arise out of and are ideologically shaped by relations of power and struggles over power; and to explore how the opacity of these relationships between discourse and society is itself a factor securing power and hegemony (pp. 132–133)”.
... Further, 'de-centering' is a skill present in mindfulness for the self to make sense of the situation or reserve judgement and to observe thoughts as events and not facts (Wells, 2005). This implies that you observe your own feeling tones without recognition of their worth. ...
Thesis
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Recently, the science behind mindfulness meditation has increasingly turned towards how and why its practice can result in such varying change. Whether it is with attention, awareness or structural brain change, research has moved more towards deconstructing mindfulness’s psychological attributes. This research investigates and identifies equanimity as one of the key facets of mindfulness therapeutic care. Therefore, the studies within this thesis were motivated by the lack of comprehensive empirical research into the construct of equanimity within Mindfulness-Based Interventions [MBIs]. Often MBIs implicitly cover equanimity; however, there are no specific psychometric scales that measure equanimity or barriers to equanimity and no primary operational definition in Western science. This restricts scientific research and understanding into the psychologically therapeutic elements of mindfulness practice. Examining the non-judgmental aspect of mindfulness further, the thesis proposes an operational definition of inner and outer equanimity, a ‘model of judgement’ and ‘naturally occurring ignorance’ before validating the first scale to measure barriers to equanimity, henceforth known as the Equanimity Barriers Scale [EBS]. Mindfulness research must be able to differentiate attention, awareness and non-judgemental facets encompassed under the umbrella of mindfulness, in order to achieve clarity over its psychological beneficence and aid further advancement in the field. The proposed model of judgement and EBS was validated by 4 separate studies. The first Principal Component Analysis (n=453) utilised in order to explore underlying factors associated with barriers to equanimity. The second study refined the factors via Confirmatory Factor Analysis (n=108) and the third study (n=302) tested convergent and discriminant validity of the scale. The final study (n=327) tested differences between groups in relation to the EBS with age, anxiety, depression and mental wellbeing. The findings demonstrate how a person with fewer barriers to equanimity is more likely to be able to emotionally regulate, have greater self-compassion, mindfulness and mental wellbeing, whereas a person who has higher barriers to equanimity has greater risk of anxiety, depression and difficulties in emotional regulation. The development of a new model and first-ever scale to measure barriers to equanimity extends the body of knowledge of the existing literature and research related to mindfulness, and more specifically, to the adoption of equanimity within person-centred therapy, clinical psychology and general health and wellbeing. The thesis therefore provides both theoretical and practical contributions to knowledge. This is critical given the current state of mental health in the world as individuals face unique challenges in relation to their own distinctive patterns of experience and individual differences on a psychological and social level. Understanding barriers to equanimity enables individuals to strengthen mindfulness practice and continue advancement in well-being with openness, acceptance and less discrimination. Therefore, the proposed thesis serves as a platform for a closer insight into personal navigation of an often-polarised world.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Chapter
Critical thinking enables us to ensure that we have good reasons to believe or do what people attempt to persuade us to do or to believe. When the question why? is involved, we look for a reason for doing an activity, or for believing what we believe. Trying to persuade somebody else by providing good reasons is to give an argument. In some respects, an argument is an alternative term for critical thinking. But it should be noted that the latter has more and broader elements, in that the process of argumentation is part of the processes of critical thinking. There are also some important differences between making an argument and thinking critically. There is a sense that one argues for a specific purpose, perhaps to “win a point,” while critical thinking emphasizes “good processing” of evidence.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Chapter
Nowadays, many people seem to see, think, and act in a robot-like way. In those moments, they break contact with what is deepest in themselves and what possibly affords them their greatest opportunities for creativity, learning, and growing. When such moments persist, one could fall into the trap of automaticity and unawareness (Kabat-Zinn, in Mindfulness meditation in everyday life. Piatkus Books, London, 2001). When their mind is automatic, this may result in a multitude of behaviors without any particular sentience, awareness, intentionality, planning, or deliberate decision-making.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Book
In this book, we try to provide a practical, down-to-earth guide for those who are involved in language learning and teaching. We hope that this book will be a useful reading for those who would like to incorporate higher-order thinking skills (HOTS)-enhancing techniques in their teaching practice. We set out from the position that, although it is hardly doubtful that it is at the heart of education, critical thinking is in reality often not given its due attention in pedagogy, particularly in language education. This book offers readers some practical advice on how to implement HOTS in their own practice. It has been written to take the reader through each technique with the ultimate goal of promoting HOTS step-by-step. In the introductory chapter, we present an overview of the theory behind HOTS, its definition, its relation to Bloom’s Taxonomy, its two dimensions (critical thinking and reflective thinking), and the ideas of some influential thinkers in this area. The subsequent chapters present six HOTS-enhancing techniques that classroom teachers can draw from, namely graphic organizers, critical discourse analysis, argumentation, emotion regulation and emotional intelligence enhancing techniques, reflective journals, and mindfulness-based strategies. As the book draws on a wide-ranging review of literature with exercises for direct use with language learners, we hope that this provides both theoretical and practical support for the teaching process to help language learners become effective critical thinkers. The compilation of the ideas in this book took us a long time, over a decade. Something that takes such a long time requires much engagement and life experience; so did this book.
... 95 Metakognitif terapide OKB için kullanılan ana yaklaşım, danışanın metabilişsel sürecinin farkında olmasına yardım etmek ve düşüncelerin önemi hakkındaki inançlar gibi üst düzey metabilişlerin değiştirilmesini öğretmektir. 96 OKB tedavisindeki metakognitif değişimdeki ilk adımlardan biri ayrık farkındalık eğitimidir. Ayrık farkındalık egzersizleri farklı teknikler aracılığıyla gerçekleştirilebilmektedir. ...
Article
Full-text available
Obsesif Kompulsif Bozukluk (OKB) bireyde istenmeyen düşüncelerin (obsesyonlar) ve zaman zaman bunlara eşlik eden istem dışı yineleyici davranışların (kompulsiyonlar) bulunduğu, bireyin işlevselliğini olumsuz yönde etkileyen bir rahatsızlıktır. OKB’nin tedavisinde bilişsel davranışçı terapi müdahalelerinin etkili olduğu bilinmektedir. Son yıllarda da bilişsel davranışçı terapiye alternatif olarak farklı psikoterapötik yaklaşımların OKB üzerindeki etkililiği incelenmektedir. OKB’nin gerek toplumdaki yaygınlığı, gerekse erken başlangıçlı olması ve bireylerin yaşamında tedavi edilmediğinde kronik bir seyir izlemesi göz önünde bulundurulduğunda psikolojik tedavi yaklaşımlarının önemi belirginleşmektedir. Bu derleme çalışmasında, OKB’nin tedavisindeki güncel yaklaşımlardan olan ve son dönemde yaygınlaşan farkındalık temelli terapilerin, kabul ve kararlılık terapisinin ve metakognitif terapinin OKB’ye bakış açısına değinilmiş ve etkililik çalışmalarına yer verilmiştir.
... Stattdessen soll die Person sich selbst als Beobachter losgelöst von Gedanken erleben. Zur Förderung der losgelösten Achtsamkeit werden spezifische DM-Techniken(Wells, 2005a) eingesetzt. Beispielsweise sollen bei der WolkenMetapher die Gedanken wie vorbeiziehende Wolken erlebt werden, in deren Lauf man als Teil der Selbstregulation der Atmosphäre nicht eingreifen kann. ...
Article
Zusammenfassung. Die metakognitive Therapie nach Wells wird den neueren kognitiven Therapieansätzen, der so genannten „dritten Welle“ der Verhaltenstherapie, zugeordnet. Sie sieht dysfunktionale metakognitive Annahmen sowie Regulationsprozesse als entscheidend für die Entstehung und Aufrechterhaltung psychischer Störungen an. Aufbauend auf dem metakognitiven Störungsmodell werden in diesem Übersichtsartikel die metakognitiven Modellannahmen erläutert und ihre empirische Relevanz für verschiedene Störungsbilder berichtet. Nach der Darstellung der zentralen Therapieelemente wird auf die aktuelle Befundlage zu Wirksamkeit und Wirkungsmechanismen der metakognitiven Therapie sowohl störungsübergreifend als auch störungsspezifisch eingegangen.
... The important question is how they are able to overcome this situation. Mindfulness helps people to raise awareness of the automatic ebb and flow of mental events (Wells, 2006). Four core elements of mindfulness; including awareness, attention, focus on the present moment, and acceptance; may have the ability to counter automaticity (Kang, Gruber, & Gray, 2013). ...
Chapter
Graphic organizers as a communication tool employ visual symbols to express knowledge, concepts, thoughts, ideas, and their associations. Graphic organizers encompass several variants, such as knowledge maps, concept maps, semantic maps, and advanced organizers with the concept maps as one of the most widely used in the educational domain (see examples below in this chapter). Concept maps facilitate comprehending the association among ideas by constructing a visual map of the connections.
... Two recent interventions [39**,41**] are based on the Conquer Fear program [53], which targets FoP-related worry and rumination with metacognitive therapy techniques such as detached mindfulness and attentional training [39**,41**]. Detached mindfulness enables patients to observe their thoughts more passively and to reduce worry and the use of avoidance coping strategies [54]. Attentional training aims to help patients shift their attention more flexibly when thoughts about recurrence occur [53]. ...
Article
Purpose of review: The purpose of this article is to review the formats and techniques of psychological interventions designed for patients with metastatic cancer and prolonged survival expectancies. Recent findings: Fifteen interventional studies were selected for this article. One group of psychological interventions focused primarily on patients' adaptation by increasing their knowledge, developing patients' stress management skills, promoting their open communication with healthcare providers, and helping them deal with existential concerns. Another group of interventions focused on patients with moderate and high levels of distress. These interventions provided specific techniques to manage anxiety, depression, fear of cancer progression, and existential distress. Interestingly, interventions targeting distressed patients are not necessarily longer or more intensive than interventions targeting adaptation. The interventions were examined in few randomized controlled trials, and incorporated a broad range of techniques, making comparison of their efficacy difficult. No intervention specifically targeted patients newly diagnosed with metastatic cancer. Summary: On the basis of this review, we proposed suggestions according to patients' levels of distress, which differ in intensity, format, techniques, and tools offered. These suggestions may be relevant for the future development and assessment of interventions targeting patients with newly diagnosed metastatic cancer and prolonged survival expectancies.
... I would like to talk about a practical application for the discussion above. In cognitive therapy, detached mindfulness [3] can be used to observe thoughts in a nonreactive manner (effective against anxiety). As I studied the extreme thought process in suicidal ideation mechanism [4] using Mindsponge theory [5,6], I suggest a slightly different perspective in this approach: instead of a detachment between perceived self and thoughts, it should be the realization of thoughts being attached to the "wrong self". ...
Preprint
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I give some demonstrations for philosophy on the self and make connection to contemporary spirituality.
... Decentering is a skill present in mindfulness that allows the self to make sense of the situation or reserve judgment and to observe thoughts as events and not facts (Wells, 2005). This implies that you observe your own feeling tones without evaluation of their worth. ...
Article
Full-text available
Despite the plethora of mindfulness research, it has been suggested that equanimity has been largely ignored. Current research has sought to add greater precision to this construct. The objectives of this systematic literature review were (1) to identify whether equanimity is being recognized as a key facet in mindfulness-based interventions and (2) to evaluate the effectiveness of equanimity as a construct in psychiatric health. The data sources were ProQuest Central and SCOPUS. A systematic literature review was conducted of peer-reviewed research articles published between 2010 and 2018. Nine studies identified equanimity as a key facet in mindfulness interventions in relation to mental health interventions. The review found that there is limited standardized inclusion of equanimity and poor reliability and generalizability surrounding this construct. Furthermore, there are no explicit instruments for measuring equanimity. More research is needed in mental health intervention to develop clarity over the impact of equanimity on well-being and psychiatric health. Further, psychometric measures for the construct are limited. The wide variety of mindfulness-based interventions (MBIs) raises the question of how explicitly equanimity is communicated. There is also a general lack of understanding and clarity regarding its operational definition. Often, equanimity can be synonymous with the terms nonjudgment or decentering. This systematic literature review aimed to address these gaps in the literature.
... Metacognitive therapy and its techniques (Wells, 2009) were specifically designed to achieve these goals and the sequence and emphasis of therapy fits with our results where we observe that (dis)trusting one's memory and the belief that one cannot stop worrying are central items in the item network of the MCQ-30, and that need for control and negative beliefs about the uncontrollability and danger of worrying are central in the domain network of the MCQ-30. In metacognitive therapy, techniques such as such as detached mindfulness (DM; Wells, 2005) and the Attention Training Technique (ATT; Wells, 1990) are introduced early in treatment and are aimed at the discovery of flexible cognitive control and at weakening beliefs about uncontrollability. Furthermore, in line with our findings and metacognitive theory (Wells & Matthews, 1994), change in beliefs about the need for control (Sunde et al., 2021) and in negative metacognitive beliefs about the uncontrollability and danger of worrying (Solem et al., 2009;Nordahl et al., 2017; are associated with symptom improvement. ...
Article
Full-text available
The Metacognitive Control System (MCS) model gives central importance to maladaptive metacognition in psychological vulnerability and disorder. The metacognitions questionnaire 30 (MCQ-30) is widely used to assess such metacognitions and to establish their effects. Previous studies consistently demonstrate that the MCQ-30 consists of five latent factors, with some factors showing wide-ranging positive associations with symptoms and some demonstrating more specific symptom links. Questions remain concerning relationships between MCQ-items (or domains) and the most central of these outside of the latent-factor model. In the present study we set out to explore the internal structure of the MCQ-30 using network analysis and estimated two graphical Gaussian models, one with items-and one with domains, in an unselected sample (N = 1080). The robustness and stability of the networks, as well as the node predictability were assessed. Among our observations was that the items of the MCQ-30 appeared to cluster in meaningful substructures, corresponding to metacognitive theory. Furthermore , "need for control" was the most centrally placed domain, suggesting it plays an important role in the network and that its activation has a strong influence on other nodes. The theoretical and clinical implications of the current findings are discussed in light of the metacognitive model of psychological disorder.
... En revanche, les données montrent une réduction de l'effet d'interférence pour les TR les plus longs après la TCC, ce qui suggère une suppression efficace de la réponse impulsive et donc une amélioration nette des performances d'inhibition après 12 semaines de TCC. Ces données confirment celles d'études précédentes ayant montré que l'on pouvait améliorer les processus inhibiteurs par remédiation cognitive [18,35,36]. L'analyse dynamique de la précision, quant à elle, révèle une diminution du taux d'erreurs rapides après la TCC, suggérant que le programme réduit la force des actions impulsives. ...
Article
Résumé Au sein de notre service, nous travaillons avec un programme de thérapie cognitive comportementale centré sur les processus attentionnels. Les parents et éducateurs rapportent les effets positifs de celui-ci sur le comportement des adolescents avec un trouble de l’attention avec hyperactivité (TDAH) mais ses effets sur des processus cognitifs précis n’ont encore jamais été testés. Cette étude s’intéresse à l’impact de ce programme sur le contrôle de l’impulsivité des adolescents avec un TDAH non traité. Nous avons utilisé la tâche de Simon (connue pour générer un conflit entre une réponse automatique et une réponse dirigée vers un but) et interprété les résultats dans le cadre théorique du modèle « Activation-suppression ». Ce cadre expérimental et théorique nous fournit un outil puissant et précis pour étudier le contrôle de l’impulsivité en dissociant l’activation et la suppression des actions impulsives, ce qui n’est quasiment jamais réalisé dans les études sur le contrôle de l’impulsivité. Vingt adolescents avec un TDAH non traité ont suivi le programme pendant 12 semaines et nous avons comparé leur performance avant et après la réalisation de ce programme. Les résultats montrent que l’amélioration du contrôle de l’impulsivité observée en fin de session vient à la fois d’une diminution de la propension à déclencher des actions impulsives et d’une augmentation de l’efficacité des processus inhibiteurs. Ce programme pourrait donc se révéler une alternative pertinente à la médication stimulante, en particulier quand les parents sont réticents face à la médication ou quand leurs enfants présentent des effets secondaires trop importants.
... DM er en tilstand av bevissthet om interne hendelser, uten å respondere til dem, forsøke å kontrollere eller undertrykke dem, eller respondere til dem atferdsmessig. Istedenfor å forsøke å kontrollere bekymringen, innebaerer bruk av DM å tillate at tanken er tilstede, og å tolke tanken som en intern hendelse i sinnet som ikke krever videre fortolkning eller handling (Wells, 2005b). DM utvikler meta-bevisstheten. ...
Thesis
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During the last two decades a number of therapies, under the name of the third wave of cognitive behavior therapy have been developed. One disorder that has gained attention from the third wave is Generalized Anxiety Disorder (GAD), a disorder cognitive behavior therapy finds difficult to treat. Four of these models for GAD are Metacognitive Therapy, Integrative Therapy, Acceptance Based Behavior Therapy, and Emotion Regulation Therapy. The purposes of this review of these third wave treatments were: 1. To describe these models, 2. To evaluate if they currently fulfill the criteria for empirically supported treatments (EST), 3. To discuss whether it is reasonably to assess the treatment models with the EST criteria, and 4: To give some recommendations to research and practice. The result demonstrates that none of the treatment models fulfilled the EST criteria. The review recommends psychologists in research and practice to implement the Policy Statement on evidence based practice in psychology of APA (2005), and broaden the view on evidence based practice.
... In general, metacognition is the individual's knowledge about what she knows (Tosun and Irak 2008), her thoughts about what she thinks (Tosun and Irak 2008;Wells 2009), and her cognition (Wells 2009). Metacognitive approach is based on the idea that people have false beliefs in case of mental illness; because it enables the formation of negative emotion patterns that respond to their metacognition inner experiences and reinforce negative ideas (Wells 2005). Studies show that metacognitive features play an important role in recurrent depressions (Sheppard and Teasdale 2004;Teasdale et al. 2001). ...
Article
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This research is carried out in the pre test-post test, control group and semi-experimental design to detect effect of metacognitive training applied on depression and cognitive distortion levels of depression patients. Total of 77 patients diagnosed with depression, including 38 experimental and 39 control groups, compose the sample of the study. The data were collected by ‘Personal Information Form’, ‘Beck Depression Inventory (BDI)’ and ‘Cognitive Distortions Scale (CDS)’. Metacognition training was applied once a week as a group training as a total of 8 sessions. In the pre-test, no significant difference was observed in the experimental and control groups in terms of the mean scores of BDI and CDS (p > 0.05). In the post-test, it was determined that the mean scores of BDI and CDS were significantly decreased in the experimental group compared to the control group (p < 0.05). In intra-group comparisons, the mean scores of mid-test and post-test BDI and CDS of the patients in the experimental group decreased significantly compared to the pre-test (p < 0.05). In the intra-group comparisons of the control group, while the mean scores of BDI decreased significantly in the post-test (p < 0.05), there was no significant different in the mean scores of the CDS (p > 0.05). It was determined that metacognition training was effective in decreasing depression and cognitive distortion levels of patients. It is recommended that metacognition training is applied by mental health professionals in the treatment of depression.
... Whereas the somatic anxiety subscale describes the physically noticeable component of anxiety, which manifests itself in signs of anxiety, such as palpitations, clammy hands, or a sinking feeling in the stomach (Brand et al., 2009), the MIS-D awareness subscale is defined as "the ability to closely observe one's internal experience like cognitions, emotions or bodily sensations in the present moment" (Thienot et al., 2014, 73-74). Additionally, mindful awareness implies a higher level of processing, a so-called meta-awareness, to reach a state of distant observation from the self, which may help the athletes to perceive their current state and internal events without responding with sustained evaluation and to detach from non-targeted sensations (Wells, 2005). In consequence, this correlation might be caused by semantic confusion while assessing mindfulness processes as Thienot et al. (2014) already elaborated. ...
Article
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Mindfulness-based training programs are highly established in competitive and recreational sports. One of the best-known approaches is the Mindfulness-Acceptance-Commitment Approach (MAC) by Gardner and Moore), which integrates mindfulness aspects of awareness, non-judgmental attitude, and focus. Based on these aspects, Thienot and colleagues developed and validated an English language sport-specific questionnaire, the so-called Mindfulness Inventory for Sport (MIS), for the assessment of mindfulness skills in athletes. The aim of this study is to psychometrically test a German language version of the MIS (MIS-D). To assess the psychometric properties, the MIS-D was examined in an online survey with an integrated test–retest design (n = 228) for reliability (internal consistency; test–retest reliability), validity (factorial; convergent), and measurement invariance (gender; competition type). The present results support the psychometric quality of the German language version of the MIS. Necessary replications should among others focus on checking the measurement invariance for further relevant subgroups.
... DM techniques that modify metacognitive knowledge and strengthen executive control of processing could act on the connectivity of cognitive and metacognitive subsystems (Wells, 2019). DM involves a detachment from thoughts, meaning that the individual is guided in separating thoughts from volitional reactions to thoughts, while keeping extended processing under control and experiencing the self as a detached observer (mindful) of mental events (Wells, 2005). The technique is used to enhance knowledge of control, enhance meta-awareness, and modify unhelpful personal models of mental functioning. ...
Article
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Metacognitive therapy (MCT) is proving to be an effective treatment for anxiety and depression with effects that may exceed CBT. It has been described as a paradigm shift in psychotherapy in its theory-driven cognitive science approach and systematic development and evaluation. MCT was developed by Adrian Wells based on an information processing theory, the Self-Regulatory Executive Function model by Wells and Matthews. MCT theory formulates psychological disorders as sharing common causal factors under the influence of metacognition, representing a particular top-down model of biases in cognitive regulation. A key clinical implication was that a core set of interventions could be developed to impact a wide range of symptoms and disorders. In this paper, we trace the historical development of MCT and the major studies that informed theory and practice with the aim of introducing clinicians and researchers to this area and to understand why the metacognitive approach has developed into a treatment that is proving to be potentially more effective than current gold-standard treatments. In doing so, we will draw out the distinctive features of the approach and explore how this might offer a blueprint for scientific advancement in clinical psychology and psychotherapy.
Article
According to the response style theory, human responses to a depressive mood are divided into two styles: ruminative and distractive responses. Although response styles reportedly have both adaptive and maladaptive aspects, the factor associated with the adaptiveness of these response styles is unclear. The present study examined the mediation and moderation effects of voluntary attention control skills (selective, divided, and switching attention) on the relationship between adaptive/maladaptive forms of ruminative/distractive response styles and depression. In total, 234 Japanese undergraduates completed questionnaires of response styles, attention control skills, and depressive symptom. Selective attention and divided attention skill mediated the effects of adaptive response styles on depression. In addition, when combined with higher divided attention skill, the increase of depression by maladaptive response styles was mitigated. These results suggest that attention control skills could explain the adaptive process of response styles, and that heightening particular skills would be efficacious in reducing depression.
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Overgeneral autobiographical memory (OGM) is considered a risk factor for depression. Previous studies have established the relationship between passive attention control and OGM. However, there are only a few studies examining the relationship between OGM and voluntary attention control. Thus, the current study aims to examine the relationship between OGM and the scores obtained from the voluntary attention control scale. We administered an online survey using a questionnaire and the autobiographical memory test (AMT) on 109 students from Waseda University. Results suggested that neutral OGM is negatively correlated with depression and positively correlated with voluntary attention control. Therefore, the study inferred that neutral OGM may have an adaptive function. However, the association between depression and OGM was not reproduced, which suggests the limitation of the online version of the AMT-OI.
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Aging seems to be a biological process all living beings, including humans, experience. Hence, it is important to pay careful attention to the elderly and to prevent disorders such as meta-cognitive beliefs and alexithymia among the elderly. Therefore, the current study was to consider the effectiveness of compassion-based therapy on meta-cognitive beliefs and alexithymia in the elderly. It was a quasi-experimental study with pretest-posttest and control group design. The statistical population of the study consisted of all the elderly men with alexithymia living in Ahvaz, Iran in 2020. The sample consisted of 30 elderly men (60 to 70 years old) selected by convenience sampling method and according to the inclusion and exclusion criteria. The experimental group received eight weekly 90-minute sessions of compassion-based therapy. The questionnaires applied in the current study included Toronto Alexithymia Scale and Wells and Cartwright-Hatton's Meta-Cognitions Scale. Data were analyzed using analysis of covariance (ANCOVA) at the confidence level of 0.05. The results showed that there was a significant difference between experimental and control groups in terms of meta-cognitive beliefs and alexithymia in the elderly (p<0.001). Put in other words, compassion-based therapy resulted in a decrease of meta-cognitive beliefs and alexithymia in the elderly. According to the findings of the present study, compassion-based therapy can be suggested as an efficient method in order to reduce meta-cognitive beliefs and alexithymia in the elderly.
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Written by internationally recognized experts, this comprehensive CBT clinician's manual provides disorder-specific chapters and accessible pedagogical features. The cutting-edge research, advanced theory, and attention to special adaptations make this an appropriate reference text for qualified CBT practitioners, students in post-graduate CBT courses, and clinical psychology doctorate students. The case examples demonstrate clinical applications of specific interventions and explain how to adapt CBT protocols for a range of diverse populations. It strikes a balance between core, theoretical principles and protocol-based interventions, simulating the experience of private supervision from a top expert in the field.
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CBT interventions are described for: - Obsessional jealousy - Body-focused repetitive behavior disorders – not otherwise specified - Body dysmorphic disorder with a visible defect - Olfactory reference syndrome.
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In metacognitive therapy (MCT), Detached Mindfulness (DM) is proposed as a state of awareness of internal events, without attempting to control them. DM is considered to be a factor to improve the mental disorders and their symptoms. DM is composed of six characteristics, and they are controlled by metacognitive knowledge. Although, previous studies have not developed a questionnaire to measure characteristics and metacognitive knowledge of DM. Therefore, we developed a questionnaire to measure the characteristics of DM and a questionnaire to measure metacognitive knowledge of DM. Also, we investigated their reliability and validity. As a result, two questionnaires were developed: Characteristics of Detached Mindfulness Questionnaire (CDMQ) and Metacognitive Knowledge about Detached Mindfulness Questionnaire (MDMQ). CDMQ almost sufficient reliability was shown. However, there remains a problem in the construct validity of the subscale, so it will be necessary to refine the items of CDMQ and to reexamine the construct validity of the whole scale. Also, MDMQ almost sufficient validity was shown. However, there remains a problem in the reliability. In the future, it will be necessary to examine the test-retest reliability of MDMQ. (182words)
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This study aimed to investigate the mediating role of metacognition in the relationship between trait mindfulness and critical thinking. 300 undergraduate students were selected by a multistage random sampling method. The California Critical Thinking Skills Test; Form B (CCTST-B), Metacognitive Awareness Inventory (MAI), and Five Facet Mindfulness Questionnaires (FFMQ) were used. Structural equation modeling was used for analyzing the data. The result indicated that trait mindfulness was positively correlated with metacognitive awareness (MA) and critical thinking. Furthermore, MA was related to critical thinking. The fit indicators of the proposed model were obtained at an acceptable and desired level. The results suggested that MA may be as a mediator of the relationship between trait mindfulness and critical thinking.
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The role of metacognition in learning and academic achievement has been recognised. Outside of education, mindfulness has been shown to enhance metacognition and subsequent outcomes (e.g., in mental health). While mindfulness has been investigated in relation to enhancing outcomes in education, less consideration has been given to the role of metacognition as a mediating factor. The current study used a between-groups design to investigate (1) whether a mindfulness intervention significantly improves learning outcomes, mindfulness and metacognition in those learning English as a foreign language and (2) whether the relationship between mindfulness and learning outcomes is mediated by metacognition. Results of the current study were not significant. However, this study represents an important step in terms of investigating mechanisms of change in educational practices. Methodological considerations and avenues for further research are discussed.
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Metacognitive therapy aims at a state of detached mindfulness (DM), in which unpleasant thoughts and feelings are left unaddressed. To achieve DM, it is important to improve attention ability. In addition, it has been suggested that it is necessary to address beliefs about maladaptive coping behaviors to promote DM in clinical settings. However, the relationship between attention ability, such beliefs, and DM has not been clarified. In the present study, we investigated the relationships between metacognitive beliefs about maladaptive coping behaviors (MBC), attention ability, and DM. A survey was administered to 147 university students. The hierarchical multiple regression analysis and multiple mediation analysis were then conducted. Results showed that the positive metacognitive beliefs of MBC were not associated with attention ability or DM, but it did had a significant moderation effect. Several negative metacognitive beliefs of the MBC were significantly correlated with attention ability and DM, and the Risk of Coping factor of the MBC had a significant mediation effect. This study suggests that it is necessary to address MBC in addition to attention ability to promote DM. Future studies may need to examine the effects of an experimental manipulation of attention ability and MBC on DM.
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Attentional avoidance is a factor that inhibits extinction learning, and covert avoidance may be independent of behavior. However, covert attentional avoidance has never been examined as a factor that inhibits extinction learning. Although threat-monitoring is considered to facilitate fear conditioning, this has not been examined. In this study, we examined (1) whether covert attentional avoidance of conditioned stimuli inhibits extinction learning and (2) whether fear conditioning is more likely to be established if trait threat-monitoring is high. In hypothesis (1), we compared the effects of extinction learning in two groups: covert attentional avoidance and covert selective attention to conditioned stimuli. In hypothesis (2), threat monitoring was measured using a self-reported questionnaire, and fear conditioning was evaluated using an experimental task. Hypothesis (1) indicates that covert attentional avoidance may also inhibit extinction learning; however, examining the participants' learning history of covert attentional avoidance would be necessary to achieve a definitive conclusion. Hypothesis (2) indicates that the high trait threat-monitoring facilitates a higher cognitive process of fear responses.
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This paper describes the theoretical background and treatment methods of Wells' Metacognitive Therapy (MCT). First, one of the fundamental theories of MCT the Self-Regulatory Executive Function (S-REF) model, is described. S-REF consists of a metasystem unit, a low-level processing unit, and a S-REF unit in which all disorders are linked to the activation of a dysfunctional pattern of cognitive processing called Cognitive Attention Syndrome (CAS). Modification of CAS plays an integral role in MCT for all emotional disorders. The two main methods of treating CAS are modifying (negative/positive) metacognitive beliefs and increasing attentional fiexibility. Using an example case of a patient with GAD, the methods for modifying metacognitive beliefs by focusing on the worry function rather than the worry content are summarized. Concerning the modification of attentional fiexibility, the Attention Training (ATT) procedure and theoretical background are illustrated from the perspective of the S-REF model. Finally, the effective use of MCT and the implications of the S-REF model for scientific development are discussed.
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Tested the 2-process theory of detection, search, and attention presented by the current authors (1977) in a series of experiments. The studies (a) demonstrate the qualitative difference between 2 modes of information processing: automatic detection and controlled search; (b) trace the course of the learning of automatic detection, of categories, and of automatic-attention responses; and (c) show the dependence of automatic detection on attending responses and demonstrate how such responses interrupt controlled processing and interfere with the focusing of attention. The learning of categories is shown to improve controlled search performance. A general framework for human information processing is proposed. The framework emphasizes the roles of automatic and controlled processing. The theory is compared to and contrasted with extant models of search and attention. (31/2 p ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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A 2-process theory of human information processing is proposed and applied to detection, search, and attention phenomena. Automatic processing is activation of a learned sequence of elements in long-term memory that is initiated by appropriate inputs and then proceeds automatically--without S control, without stressing the capacity limitations of the system, and without necessarily demanding attention. Controlled processing is a temporary activation of a sequence of elements that can be set up quickly and easily but requires attention, is capacity-limited (usually serial in nature), and is controlled by the S. A series of studies, with approximately 8 Ss, using both reaction time and accuracy measures is presented, which traces these concepts in the form of automatic detection and controlled search through the areas of detection, search, and attention. Results in these areas are shown to arise from common mechanisms. Automatic detection is shown to develop following consistent mapping of stimuli to responses over trials. Controlled search was utilized in varied-mapping paradigms, and in the present studies, it took the form of serial, terminating search. (60 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Cognitive therapy techniques are applied to an ever-increasing range of psychological disorders. However, both basic methods and general theory of therapy have evolved more slowly. Although cognitive therapy is based on experimentally testable concepts derived from cognitive psychology, an integration of these areas capable of explaining cognitive-attentional phenomena and offering treatment Implications remains to be achieved. In this paper, we outline the Self-Regulatory Executive Function (S-REF) model of emotional disorder, which integrates information processing research with Beck's schema theory. The model advances understanding of the roles of stimulus-driven and voluntary control of cognition, procedural knowledge (beliefs), and of the interactions between different levels of information-processing. It also accounts for cognitive bias effects demonstrated in the experimental psychopathology literature. The model presents implications concerning not only what should be done in cognitive therapy, but how cognitive change may be most effectively accomplished.
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Working largely independently, numerous investigators have explored the role of self-focused attention in various clinical disorders. This article reviews research examining increased self-focused attention in these disorders. Results indicate that regardless of the particular disorder under investigation, a heightened degree of self-focused attention is found. Hence, as ordinarily conceptualized, self-focused attention has little discriminatory power among different psychological disorders. Using information processing constructs, a somewhat different model of self-focused attention is proposed, and it is suggested that certain deviations in this process constitute a psychopathological kind of attention. A meta-construct model of descriptive psychopathology is then outlined to examine how certain aspects of attention can be considered specific to certain disorders and others common to different disorders.
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This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients (n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.
Chapter
This chapter focuses on research program, providing a description of a theoretical framework that has evolved out of metamemory research, followed by a few remarks about the methodology. Research in metamemory is initiated by the paradoxical findings that people can accurately predict their subsequent likelihood of recognizing nonrecallable items and that they can quickly and accurately decide-on the basis of no more than a cursory search through memory-that they will not retrieve particular sought after items. Those findings lead to develop a methodology based on psychophysical methods that are used to empirically investigate people's feeling of knowing. The results of the experiments convinced that for dealing with only a part of a complex metacognitive system and to account adequately for feeling-of-knowing phenomena, a larger perspective was needed. This eventuated in the present theoretical framework that emphasizes the role of control and monitoring processes. The embedding of the feeling of knowing in a richer framework helped to dissipate the paradoxical nature of the feeling of knowing. The chapter discusses that today there are many capable, active investigators and a wealth of solid empirical findings.
Book
The clinical experience of cognitive therapies is adding to the understanding of emotional disorders. Based on clinical experience and evidence, this groundbreaking book represents a development of cognitive therapy through the concept of metacognition. It provides guidelines for innovative treatments of emotional disorders and goes on to offer conceptual arguments for the future development of cognitive therapy. Offers a new concept in cognitive therapy and guidelines for innovative treatment. Clinically grounded, based on a thorough understanding of cognitive therapies in practice. Written by a recognized authority and established author.
Book
An ACT Approach Chapter 1. What is Acceptance and Commitment Therapy? Steven C. Hayes, Kirk D. Strosahl, Kara Bunting, Michael Twohig, and Kelly G. Wilson Chapter 2. An ACT Primer: Core Therapy Processes, Intervention Strategies, and Therapist Competencies. Kirk D. Strosahl, Steven C. Hayes, Kelly G. Wilson and Elizabeth V. Gifford Chapter 3. ACT Case Formulation. Steven C. Hayes, Kirk D. Strosahl, Jayson Luoma, Alethea A. Smith, and Kelly G. Wilson ACT with Behavior Problems Chapter 4. ACT with Affective Disorders. Robert D. Zettle Chapter 5. ACT with Anxiety Disorders. Susan M. Orsillo, Lizabeth Roemer, Jennifer Block-Lerner, Chad LeJeune, and James D. Herbert Chapter 6. ACT with Posttraumatic Stress Disorder. Alethea A. Smith and Victoria M. Follette Chapter 7. ACT for Substance Abuse and Dependence. Kelly G. Wilson and Michelle R. Byrd Chapter 8. ACT with the Seriously Mentally Ill. Patricia Bach Chapter 9. ACT with the Multi-Problem Patient. Kirk D. Strosahl ACT with Special Populations, Settings, and Methods Chapter 10. ACT with Children, Adolescents, and their Parents. Amy R. Murrell, Lisa W. Coyne, & Kelly G. Wilson Chapter 11. ACT for Stress. Frank Bond. Chapter 12. ACT in Medical Settings. Patricia Robinson, Jennifer Gregg, JoAnne Dahl, & Tobias Lundgren Chapter 13. ACT with Chronic Pain Patients. Patricia Robinson, Rikard K. Wicksell, Gunnar L. Olsson Chapter 14. ACT in Group Format. Robyn D. Walser and Jacqueline Pistorello
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This article describes a new brief treatment for PTSD based on a metacognitive model (Wells, 2000). The treatment derived from this approach can be divided into core and supplementary treatment components. The core treatment manual is presented here. The core treatment does not require imaginal reliving of trauma or cognitive challenging of thoughts and beliefs about trauma. It enables patients to develop a metacognitive perspective and disengage unhelpful thinking styles such as worry/rumination and attentional monitoring that block the natural propensity for cognitive-emotional adaptation following trauma. The content, techniques, and sequence of the basic program are described in detail to support practical application of the new treatment by therapists.
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This study evaluated the effectiveness of Attention Training (ATT; Wells, 1990) in the treatment of recurrent major depression. This technique is based on an information processing model of emotional disorders (Wells & Matthews, 1994) in which self-focused attention and metacognition maintain dysfunction. ATT was evaluated in a consecutive single-case series of patients referred for treatment of recurrent major depression. Patients were assigned to no-treatment baselines of 3 to 5 weeks, administered five to eight weekly sessions of ATT, and followed up at 3, 6, and 12 months posttreatment. The effects of ATT on depression, anxiety, negative automatic thoughts, rumination, self-focused attention, and metacognition were assessed. Following ATT, all patients showed clinically significant reductions in depression and anxiety. Reductions in negative automatic thoughts, rumination, and attentional and metacognitive factors showed similar improvements. All scores fell within the normal range on completion of ATT. Treatment gains were maintained at the 12-month follow-up assessments. However, randomized controlled trials of ATT are required before firm conclusions can be drawn.
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Automatic/controlled processing theory is reviewed with emphasis on applications to research on attention. Automatic/controlled processing theory assumes that human performance is the result of two qualitatively different processes; automatic and controlled processing. Automatic processing is a fast, parallel process not limited by short term memory. Automatic processing uses little subject effort, permits little direct subject control, but requires extensive and consistent training to develop. Controlled processing is a comparatively slow, serial process limited by short term memory. Controlled processing requires subject effort, permits a large degree of subject control, but needs little training to develop. Attention paradigms discussed include selective attention, focused attention, and attentional capacity. Conclusions from the application of automatic and controlled processing determines performance; paradigms suggest that: (1) performance differs to the degree that automatic or controlled processing determines performance; (2) performance improves with extensive consistent practice; (3) automatic processes are difficult to control; and (4) capacity reductions primarily harm controlled processing. The development of automatic processing is examined, and performance is seen to improve as a function of consistent executions.
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[This book] is written for students of cognitive psychology, and also for clinicians and researchers in the areas of cognition, stress and emotional disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
In an earlier article (J. R. Martin, 1997a), I proposed a common factor of mindfulness that can be found in all psychotherapy orientations. Mindfulness was defined as a state of psychological freedom that occurs when attention remains quiet and limber, without attachment to any particular point of view. In the present commentary, I explore some linkages between this common factor and M. J. Horowitz's (see record 2002-13441-001) ideas regarding self- and relational observation. His article offers several promising ideas for psychotherapy integration and the potential development of effective psychotherapy interventions. It also expands the discourse related to a mindfulness factor (J. R. Martin, 1997a) and its facets, linkages, and its implications for clinical practice. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This book helps to develop an understanding of the internal rules and processes that guide thinking, and the factors that lead individuals to become trapped in cycles of negative and distorted thought. In a new approach to cognitive therapy, A. Wells addresses limitations of cognitive theories and describes how metacognition, self-attentional processes, and worry/rumination strategies are central to emotional vulnerability, to the maintenance of trauma-related stress reactions, to and emotional disorders. Using the meta-cognitive model, the author describes in detail new clinical strategies which help to guide the clinician towards a fresh cognitive approach to changing negative thoughts, distorted beliefs, and distressing emotions. The audience for this book includes trainee therapists, practitioners, and experts working at the frontiers of cognitive therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This study tested the effectiveness of a new cognitive technique involving attention training. A single case systematic replication series (Sidman, 1960) was used to replicate and extend previous findings. In particular the effects of attention training on panic frequency, general anxiety, and beliefs was investigated across two panic disorder cases and one social phobia case, and across different therapists, and settings. A true reversal design was used in one of the cases. In this case attention training was followed by an attentional manipulation incompatible with the hypothesized effects of attention training so that the effects of attention training on target problems could be clearly evaluated on its re-introduction. The results are consistent with those of a previous study (Wells, 1990) and provide preliminary evidence that panic attacks, anxiety and beliefs can be effectively and lastingly reduced by cognitive techniques which do not directly target the content of negative appraisal. © 1997 John Wiley & Sons, Ltd.
Article
When entering anxiety-provoking social situations, individuals with social phobia tend to shift attention inward, toward the self. This tendency is likely to diminish the potential for exposure to correct negative beliefs and associated anxiety. The present study tested the hypothesis that by shifting to an external attention focus on disconfirmatory information, the effectiveness of brief exposure is increased. This hypothesis was tested in a single-case series of 8 socially phobic patients. Following an initial behavior test, half of the patients received one session of exposure alone followed by one session of exposure plus external attention focus, while the other half of the patients received these sessions in reversed order. Both conditions were rated as equally credible. Exposure plus external attention focus was significantly more effective than exposure alone in reducing within-situation anxiety and belief in feared catastrophes. Moreover, the attention condition produced a shift from an observer to a field perspective in patients' images of the feared social situation. A manipulation-check measure of degree of self-focused attention confirmed that the attention manipulation had influenced self-focus as intended. The role of attention manipulations in the treatment of social phobia is discussed.
Article
The gap between what learners can do and what they actually do can be narrowed down to a great extent by the notion of mindfulness. This construct is defined as the volitional, metacognitively guided employment of non-automatic, usually effortful processes. Mindfulness is a mid-level construct which reflects a voluntary state of mind, and connects among motivation, cognition, and learning. It is both a general tendency and a response to situational demands. This dimension of mindfulness-mindlessness, plays various important roles in different kinds of learning and transfer situations, and for different kinds of learners. Theoretical, operational, and educational implications of this dimension are discussed.
Article
A case of relaxation induced anxiety in a patient with Panic Disorder is reported. The study reports the use of an attentional training procedure which was effective in eliminating panic and facilitated tension reduction without producing anxiety. A two treatment (ABCB) design revealed that a procedure evoking external attentional focus eliminated panic attacks, whereas autogenic training increased the frequency of panic attacks and the intensity of anxiety. The possible roles of self-focus in mediating panic and the effects of relaxation are briefly discussed.
Article
Empirical evidence indicates that manipulations of attention may facilitate changes in cognition and stress symptoms in emotional disorder. The present study reports the effects of Attention Training (ATT) in a brief case series of three patients with primary hypochondriasis using an A-B-A design. ATT produced clinically significant improvements in self-reported measures of affect, and illness-related behaviour and cognition. Treatment gains were maintained at 6 months follow-up assessments. Measures of body-focused attention indicated that the ATT procedure acted on attentional processes as intended. The present case series extends the effects of ATT to problems of hypochondriasis. A number of studies now suggest that ATT is associated with a reduction in anxiety and negative beliefs across disorders of panic, social phobia and hypochondriasis. Controlled clinical trials are now required to establish firmly the effects of ATT as a component of cognitive therapy.
Article
Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced self-awareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress.
Article
The effectiveness of a new treatment for post traumatic stress disorder (PTSD) is addressed. Treatment was based on a metacognitive theory of mechanisms by which natural traumatic processing is enabled or hindered by coping strategies. It suggests that elimination of worry/rumination, of maladaptive attention strategies, and enhancing metacognitive flexibility, will permit natural processing and a return to normal cognition. An A-B direct replication series (n = 6) with follow-up assessments at 3, 6, and 18-41 months was implemented. Treatment commenced 3-10 months post-trauma. All patients showed large and statistically significant improvements in general emotion and specific PTSD measures. Gains were maintained at follow-up. Two further consecutively referred patients were treated at 8 and 12 months post-trauma to add to sample size (n = 8). Overall Post treatment effect sizes were large, ranging from 3.0 to 5.0. Further evaluations are clearly warranted.
Article
Metacognitive beliefs about the threatening meaning and significance of intrusions are fundamental to the development and maintenance of obsessive-compulsive disorder (OCD) in the metacognitive model (Cognitive therapy of anxiety disorders: a practice manual and conceptual guide, Chichester, UK, Wiley, 1997; Emotional disorders and metacognition: innovative cognitive therapy, Chichester, UK, Wiley, 2000). This predicts that reductions in metacognitive beliefs about intrusions will result in decreased anxiety and compulsions. It was hypothesized that brief (5min) exposure and response prevention configured as a behavioural experiment to challenge metacognitive beliefs would lead to reductions in anxiety, thought fusion beliefs and the urge to neutralize. Furthermore, these reductions would be greater than the effects observed in the same exposure and response prevention task, accompanied by a habituation rationale. The results were consistent with the hypotheses. The clinical implications for the treatment of OCD are discussed.
Attention Training and Hypochondrias: Preliminary Results of a Controlled Treatment Trial. Paper presented at the World Congress of Cognitive Therapy
  • M J Cavanagh
  • J Franklin
Cavanagh M. J., & Franklin, J. (2000). Attention Training and Hypochondrias: Preliminary Results of a Controlled Treatment Trial. Paper presented at the World Congress of Cognitive Therapy, Vancouver, Canada.
Treatment of recurrent major depression with Attention Training Cognitive and Behavioural Practise
  • C. Papageorgiou