A Systematic Review of Efficacy of the Attention Training Technique in Clinical and Nonclinical Samples

Abstract

These preliminary results suggest ATT may be effective in treating anxiety and depressive disorders and help remediate some symptoms of schizophrenia. Although a limited number of studies with small sample sizes warrants caution of interpretation, ATT appears promising and future studies will benefit from adequately powered RCTs.

Efficacy of metacognitive therapy in improving mental health: A meta‐analysis of single‐case studies

“…Together, these results support the use of metacognitive therapy or attention training technique as an evidence‐based intervention to treat emotional disorders. This result corroborates previous meta‐analyses conducted on group designs that showed a medium to large effect on mental health outcomes of metacognitive therapy or attention training technique as a stand‐alone treatment (Knowles et al., ; Normann et al., ). In addition, at the longest follow‐up measure available, 77.36% of the individuals were considered recovered or improved, with the problem being eliminated or improvement being maintained during the intervention phase.…”

“…Although it is difficult to provide an optimal dosage of metacognitive therapy or attention training technique sessions, Knowles et al. () and Wells () generally considered that changes can be seen after a few weeks when weekly attention training technique sessions, guided by the therapist, are associated with daily personal practice at home. Nevertheless, Wells () mentioned that more severe cases might require more intensive practice of the attention training technique.…”

“…Regarding other moderators, the results indicated at the study level a significant dose-response relationship, that is, the greater the number of sessions, the better the outcomes. Although it is difficult to provide an optimal dosage of metacognitive therapy or attention training technique sessions, Knowles et al (2016) and Wells (2009) More generally, according to Hansen, Lambert, and Forman (2002), in the clinical trials literature, between 57.6% and 67.2% of patients with Axis I disorders improve within an average of 12.7 sessions. The results also showed that gender moderated the efficacy of metacognitive therapy on the outcomes, as women showed worse outcomes than men did.…”

Executive Control Deficits Potentiate the Effect of Maladaptive Metacognitive Beliefs on Posttraumatic Stress Symptoms

“…Although evidence supports the use of metacognitive therapy for treating individuals with PTSD (Wells et al, 2015), the attention training technique (Wells, 1990, 2009) remains underutilized as a component of this larger treatment package. Results of the present study, in combination with evidence that the attention training technique reduces symptoms of emotional disorders as a standalone intervention (e.g., Fergus and Bardeen, 2016; Knowles et al, 2016), suggest that using the attention training technique to directly target executive control deficits may be an important adjunct to more established PTSD interventions. Moreover, given the applicability of the observed interaction to all four PTS symptom clusters, metacognitive therapy, including the attention training technique, may be particularly well-suited for treating individuals with PTSD.…”

Breaking the Cybernetic Code: Understanding and Treating the Human Metacognitive Control System to Enhance Mental Health

“…Hagen et al, 2017;Papageorgiou et al, 2018;Callesen et al, 2019) and of individual treatment techniques (e.g. Knowles et al, 2016). The majority of treatment outcome studies have been conducted in anxiety and depression, but preliminary feasibility data suggest that the treatment can be implemented in psychosis (Morrison et al, 2014;Carter and Wells, 2018), transdiagnostic group settings (Capobianco et al, 2018c), comorbidity , treatment resistant cases Winter et al, 2019), alcohol abuse (Caselli et al, 2018), and traumatized borderline personality .…”