Combining Metacognitive Strategies with Traditional Cognitive Behavior Therapy in Generalized Anxiety Disorder: A Case Illustration

CONTEXT: Generalized anxiety disorder (GAD) is a challenging clinical condition to manage. Recent psychological models of GAD emphasis on the need to focus on metacognitive processes in addition to symptom reduction. AIMS: We examined the application of metacognitive strategies in addition to conventional cognitive behaviour therapy (CBT) techniques in an adult patient with GAD. SETTINGS AND DESIGNS: Asingle case design with pre- and post-assessments on clinician-rated scales was adopted. MATERIALS AND METHODS: Twelve weekly sessions of therapy were conducted on an outpatient basis. Assessments were carried out on clinical global impressions scales, Hamilton's anxiety rating scale at pre- and post-therapy points. STATISTICAL ANALYSIS: Pre- and post-therapy changes were examined using the method of clinical significance. RESULTS: A combination of traditional CBT with MCT was effective in addressing anxiety and worry in this patient with GAD. The case illustrates the feasibility of matching therapeutic strategies to patient's symptom list and demonstrates a blend of metacognitive strategies and conventional CBT strategies. CONCLUSIONS: In clinical practice, matching strategies to patient's problem list is important to be an effective approach.