Beyond Cognition: The Transition from CBT to MCT in Overcoming a Therapeutic Impasse
Francesco Ziglioli
This paper presents a theoretical and clinical comparison between Cognitive Behavioural Therapy (CBT) and metacognitive therapy (MCT) in the treatment of adjustment disorder. The article first examines the epistemological differences between the two approaches, distinguishing between the CBT stance, focused on content modification, and the MCT stance, oriented towards the regulation of mental processes. Through the analysis of a clinical case, it is illustrated how cognitive restructuring can sometimes encounter a therapeutic impasse, inadvertently fuelling hyper-reflexivity and the maintenance of cognitive-attentional syndrome. The study describes the transition from CBT to MCT, highlighting how the introduction of techniques such as the attention training technique and detached mindfulness allows the deadlock to be overcome by targeting procedural flexibility. The conclusions offer practical insights for guiding clinicians in treatment selection when faced with high process activity, integrating research data with the operational complexity of the psychotherapeutic setting.
Keywords
Cognitive behavioural therapy; Metacognitive therapy; Worry; Rumination; Therapeutic impasse.
