Metacognitive Training for Depression (D-MCT)

Metacognitive training for depression (D-MCT) is a new treatment concept for depression. It is conceptualized as a variant of cognitive behavioral therapy (CBT) that adopts a metacognitive perspective to focus on the modification of cognitive biases and dysfunctional beliefs (for an overview see Dietrichkeit et al., 2020). The training seeks to enable group members to recognize and correct their often automatic and unconscious thought patterns. To this end, D-MCT teaches participants about depressive thought patterns using creative and engaging strategies along with practical examples from daily life. It also targets dysfunctional assumptions about one’s thought processes as well as dysfunctional coping strategies (e.g., social withdrawal, thought suppression, rumination as problem-solving). While the training was inspired by Metacognitive Training (MCT) for Psychosis, it focuses on different (i.e., depression-specific) cognitive biases.

The feasibility and effectiveness of a beta version of the training were confirmed in an open-label pilot study (Jelinek et al., 2013). The training proved to be effective in reducing depressive symptoms at a medium effect size (Cohen’s d between 0.56 and 0.73). Moreover, cognitive biases and rumination were significantly reduced and self-esteem was increased (effect sizes between d = 0.26 and 0.64). The experience from the pilot study helped to improve the training material. The updated version was compared to health-training in a randomized control trial (funded by the vffr).

All patients also received a standard psychosomatic outpatient treatment program at the RehaCentrum Hamburg. At the end of the treatment, as well as 6 months later at follow-up, symptom improvement was greater in the D-MCT than the health-training group (Jelinek et al., 2016), and change in depression was mediated by a decrease in dysfunctional metacognitive beliefs, particularly ‘need for control’ (Jelinek et al., 2017b). Superior effects of the D-MCT were still present 3.5 years later in secondary analyses (Jelinek et al., 2019). Moreover, analyses of subjective appraisal ratings suggest that patient acceptance of D-MCT is high while side effects are low (Diedrichkeit et al., 2021, Jelinek et al., 2017a).


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Please also note that we have developed e-learning programmes for the MCT and D-MCT: |

Core members

  • Prof. Dr. Lena Jelinek
  • Dr. Marit Hauschildt
  • Dr. Brooke Schneider
  • Dr. Judith Peth
  • Prof. Dr. Steffen Moritz

Cooperation partners

  • Prof. Dr. Sönke Arlt (Klinik für Psychiatrie und Psychotherapie, UKE, Hamburg)
  • Dr. Mona Dietrichkeit (Asklepios Klinik Nord – Ochsenzoll)
  • Dr. Marion Hagemann-Goebel (Asklepios Klinik Nord – Ochsenzoll)
  • Dr. Sandra Leh-Seal (Praxis für Neuropsychologie & Entwicklungsförderung (NEF), Meilen, Zürich, Schweiz)
  • Prof. Dr. Christian Otte (Klinik für Psychiatrie und Psychotherapie, Charité, Berlin)
  • Dr. Anne Runde (Klinik für Psychiatrie und Psychotherapie, UKE, Hamburg)
  • Sarang D. Thakkar (Asklepios Klinik Nord – Ochsenzoll)

Dietrichkeit, M., Hagemann-Goebel, M., Nestoriuc, Y., Moritz, S., & Jelinek, L. (2021). Side effects of the Metacognitive Training for Depression compared to a cognitive remediation training in patients with depression. Scientific Reports.

Dietrichkeit, M., Moritz, S., & Jelinek, L. (2020). Die Behandlung psychischer Störungen mittels metakognitiver Interventionen am Beispiel des Metakognitiven Trainings für Depression (D-MKT). [The treatment of mental disorders using metacognitive interventions using the example of Metacognitive Training for Depression (D-MKT)]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 68, 160–170.

Jelinek, L., Faissner, M., Moritz, S., & Kriston, L. (2019). Long-term efficacy of Metacognitive Training for Depression (D-MCT): a randomized controlled trial. British Journal of Clinical Psychology, 58, 245–259.

Jelinek, L., Hauschildt, M., & Moritz, S. (2015). Metakognitives Training bei Depression. Weinheim: Beltz.

Jelinek, L., Hauschild, M., Wittekind, C. E., Schneider, B. C., Kriston, L., & Moritz, S. (2016). Efficacy of Metacognitive Training for Depression (D-MCT): a randomized controlled trial. Psychotherapy and Psychosomatics, 85, 231–234.

Jelinek, L., Moritz, S., & Hauschildt, M. (2017a). Patients’ perspective on treatment with Metacognitive Training for Depression (D-MCT): results on acceptability. Journal of Affective Disorders, 221, 17–24.

Jelinek, L., Otte, C., Arlt, S., & Hauschildt, M. (2013). Denkverzerrungen erkennen und korrigieren: Eine Machbarkeitsstudie zum Metakognitiven Training bei Depressionen (D-MKT). [Identifying and correcting cognitive biases: a pilot study on the Metacognitive Training for Depression (D-MCT)]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 61, 1–8.

Jelinek, L., Van Quaquebeke, N., & Moritz, S. (2017b). Cognitive and metacognitive mechanisms of change in Metacognitive Training for Depression. Scientific Reports, 7, 3449.

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