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Title: A randomised controlled-trial of metacognitive therapy versus exposure therapy for post-traumatic stress disorder
Author: Proctor, Dawn
ISNI:       0000 0001 3502 2785
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2008
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Background: Chronic post-traumatic stress disorder (PTSD) occurs frequently and is characterised by an unremitting course (Kessler et al. 1995). Despite the availability of effective treatments a significant proportion of clients remain symptomatic following intervention (Cahill & Foa, 2004). Existing approaches seem inadequate to tackle this growing problem. Metacognitive therapy (MCT) is a novel approach and has demonstrated efficacy (Wells et al. 2008). This research compared MCT with Exposure therapy and a waitlist control condition (WL). Method: Participants (N=32) with symptom chronicity of~ 3 months were recruited for this . randomised controlled trial (RCT) from four Clinical Psychology Departments across the North West of England. Following an initial assessment those opting into the trial were randomly assigned to one of the three conditions, eight sessions of therapy (MCT v. Exposure) or an eight week wait period (WL) followed by a second randomisation to receive one of the active treatments. It was hypothesised that both active treatments would lead to significant reductions in PTSD, depression and anxiety symptoms compared with the WL and MCT would generate a faster rate of change compared with Exposure. The Impact of Events Scale (IES) was the primary outcome measure. Evaluations were conducted at pre-treatment and post-treatment time points. Results: Both MCT and Exposure resulted in statistically significant reductions in symptoms of PTSD, anxiety and depression compared with the WL control. MCT led to greater reductions than Exposure across symptoms of psychological distress and physiological arousal. Eighty-two percent of those completing MCT and 64% of the Exposure group met clinical significance criteria for recovery at post-treatment. In conclusion, MCT appears to be a highly effective treatment for PTSD when compared with traditional approaches. The clinical implications and suggestions for future research are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available