Metacognitive therapy (MCT) can help you change how you relate to your thoughts.
It can reduce worry and support people with many different mental health conditions.
MCT helps you manage your emotions and responses more effectively.
You don’t have to believe every thought that pops into your head. Metacognitive therapy (MCT), a type of cognitive behavioral therapy (CBT), helps you notice unhelpful thinking patterns and change how you respond to them. Instead of getting stuck in worry or rumination, you can learn to step back, shift your focus, and feel more at ease with your thoughts.
The core principles of metacognitive therapy
The core idea of MCT is that it helps you change how you relate to your thoughts — not just the thoughts themselves. MCT looks at your metacognitive beliefs, which are the things you believe about your own thinking. For example, you might think, “Worrying keeps me safe,” or, “I can’t stop my racing thoughts.” These beliefs can lead to unhelpful patterns, like constant worry or ruminating thoughts.
The main goals of MCT are to break these patterns and help you step back from your thoughts. In therapy, you practice skills that reduce the power your thoughts hold over you. Research shows that MCT is effective for anxiety disorders, depression, and other mental health conditions.
To put it simply, here’s how MCT differs from CBT:
CBT works on what you think by challenging negative or untrue thoughts.
MCT works on how you think by changing your relationship to thoughts so they don’t control you.
Both types of therapy can be powerful tools, but MCT gives you a new way to step back from your mind and find more freedom from unhelpful thought patterns.
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How metacognitive therapy works
In a MCT session, your therapist helps you notice unhelpful thinking patterns and practice responding differently.
Common MCT techniques include:
Attention training: Helps you practice shifting your focus away from unhelpful thoughts
Detached mindfulness: Teaches you to observe your thoughts without getting pulled in or reacting to them
Challenging unhelpful beliefs: Allows you to question thoughts like, “Worrying keeps me safe,” and practice thinking about your mind in a more balanced way
The benefits of MCT can include reducing anxiety and gaining confidence in managing stress. Most people see meaningful changes in a short time — often after 10 to 12 weekly sessions, although the exact length depends on your needs and goals. With consistent practice, MCT can help you feel less stuck and freer to focus on your life.
What metacognitive therapy can treat
Metacognitive therapy can help with a wide range of mental health conditions. It’s often used for conditions that involve worry or unhelpful thinking patterns getting in the way of daily life.
Common issues MCT can address include:
Anxiety: Excessive worry or nervousness about everyday situations
Obsessive-compulsive disorder (OCD): Repetitive thoughts and behaviors that feel uncontrollable
Depression: Persistent low mood, negative thinking, and rumination
Post-traumatic stress disorder (PTSD): Distressing thoughts or hypervigilance related to past trauma
Psychosis: Distressing or false beliefs or perceptions
ADHD-related overthinking: Racing thoughts or difficulty focusing due to persistent mental loops
MCT can also be helpful for other patterns of unhelpful thinking, like chronic stress or disordered eating. You don’t need a formal diagnosis to benefit from MCT.
Getting started with metacognitive therapy
The first step is finding a therapist trained in MCT. You can ask your current provider for a referral. You can also search online for licensed therapists who specialize in this approach.
While working with a therapist, you can practice simple self-help skills to support treatment. Helpful strategies include:
Noticing your thoughts: Pay attention to when your mind gets stuck on worries.
Stepping back from thoughts: Practice observing your thoughts without reacting or judging them.
Journaling: Write down your thoughts and feelings to help track patterns.
MCT can be used alongside other treatments, like medication or CBT, to help you manage symptoms more effectively.
The biggest shift happens when clients realize that thoughts aren’t facts. Once they see that they can notice a thought without reacting to it, the thoughts lose their power — and that can bring a real sense of calm.
Brandy Chalmers, LPC
Clinical reviewer
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Metacognitive therapy helps you notice unhelpful thinking patterns and change how you respond to them. By learning to step back from your thoughts, you can reduce worry and feel more at ease with your thoughts. Support is available from trained therapists who can guide you and help you practice these skills.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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