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Therapy role-play · MCT
Adrian Wells developed Metacognitive Therapy to treat how people think, the worrying and ruminating themselves, rather than what they think about. You practise staying out of the content of the worry. For anyone trained to test the content of thoughts, this is the hardest habit to break.
Why this therapy
For some clients the problem is not what they worry about. It is the hours they spend worrying, and the belief that they cannot stop. MCT changes those beliefs about thinking itself, so the client can let a worry sit there and move on rather than engage with it. The moment you start weighing the evidence for and against the feared outcome, you have slipped into a different therapy and are feeding the worry.
Each protocol follows its published treatment model, and so does your feedback.
Simulated clients are a training aid. They do not replace supervised work with real clients.
Each one is reviewed in your debrief, with one concrete thing to try next time.
Map the cognitive-attentional syndrome with the client: the worry, the rumination, the scanning for threat, and the coping that keeps it all going.
Help the client notice a thought and leave it alone. It is not distraction, not relaxation, and not pushing the thought away.
Set up postponement as an experiment with a prediction, then review it. Without the prediction it is a coping trick, and it proves nothing about control.
Challenge the beliefs that worry is uncontrollable, dangerous or useful, and in that order: uncontrollability first.
Deliver and review the Attention Training Technique (ATT) to loosen the grip of worry and rumination. It trains flexible attention; if the client is using it to feel calm, it is being done wrong.
The same client carries across modes. Start where you feel comfortable, then stretch.
Each client comes with a history, a presentation and measures. Read the referral as you would on placement, then begin.
The client responds to how you work. Make your mistakes here, where they cost nothing; hints come only if you ask for them.
A clear debrief on the core skills of your model (the CTS-R for CBT). Then take any one skill into a focused drill and work on it until it holds.
CBT tests whether a worry is true. MCT leaves the content alone and changes what the client believes about worrying, and how they respond to the thought.
Noticing a thought without engaging with it and without trying to push it away. The thought stays; attention moves on.
Practise MCT with us
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