Group vs. Individual Metacognitive Therapy for Generalized Anxiety Disorder
ConditionGeneralized Anxiety Disorder
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorSorlandet Hospital HF
About this trial
Generalized anxiety disorder (GAD) is a serious and long-lasting condition that can greatly reduce quality of life, work functioning, and use of health services. Metacognitive therapy (MCT) is an effective treatment for GAD, but it is not yet known whether individual MCT or group-based MCT provides the best results for patients.
This randomized controlled trial will compare two formats of MCT: individual treatment and group-based treatment (g-MCT). A total of 64 adults with GAD (32 in each treatment arm) will participate after providing informed consent. Participants will complete questionnaires, undergo clinical assessments, and allow the study to collect relevant health information from official registries.
The main aim of the study is to determine whether group-based MCT is non-inferior to individual MCT. A non-inferiority design tests whether the group format is not meaningfully less effective than the individual format. If group MCT is shown to have similar effects on anxiety symptoms and functioning, it could offer an efficient and resource-saving alternative in routine clinical care.
This will be the first study to systematically compare these two treatment formats in a real-world clinical setting. If group MCT proves to be as effective as individual therapy, it may help increase access to evidence-based treatment for people with GAD, reduce strain on mental health services, and support the development of more accessible and cost-effective care.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
Bipolar disorder;
Psychosis;
Ongoing substance abuse/dependence;
Intellectual disability based on previous medical history;
Trial design
Design model
Parallel
Treatments tested in this trial
Individual Metacognitive Therapy
BehavioralIndividual metacognitive therapy (MCT) is delivered by a trained clinician following the established protocol for generalized anxiety disorder. The treatment focuses on modifying maladaptive metacognitive beliefs, reducing the cognitive-attentional syndrome (CAS), and promoting flexible attentional control. Participants receive 10 weekly individual sessions, each lasting approximately 45 minutes. The intervention targets excessive worry, unhelpful coping strategies, and beliefs about the uncontrollability and danger of worry.
Group Metacognitive Therapy
BehavioralGroup Metacognitive Therapy (g-MCT) is delivered by two trained clinicians following the established group MCT protocol for generalized anxiety disorder. Treatment is provided in small groups of 4-6 participants and focuses on modifying maladaptive metacognitive beliefs, reducing the cognitive-attentional syndrome (CAS), and improving attentional flexibility. Participants attend 10 weekly sessions, each lasting approximately 90 minutes.
Treatment groups
64 Participants
are divided into 2 treatment groupsGroup A: Individual Metacognitive Therapy (MCT)Active comparator 1 intervention
Group B: Group Metacognitive Therapy (g-MCT)Experimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Generalized Anxiety Disorder-7 (GAD-7)
The Generalized Anxiety Disorder-7 (GAD-7) is a validated 7-item self-report measure assessing the severity of generalized anxiety symptoms over the past two weeks. Total scores range from 0 to 21, with higher scores indicating greater symptom severity. The primary outcome is change in GAD-7 score from pre-treatment (baseline, one week before treatment start) to post-treatment (one week after the last therapy session) and 3- month and 12- month follow up. The measure is widely used in clinical research and has demonstrated strong reliability, sensitivity to change, and clinical validity in GAD populations.
Time frame
Pre-treatment (baseline; one week before treatment start) mid-treatment A (the day after therapy session 4), mid-treatment B (The day after therapy session 7), post-treatment (one week after the last therapy session), 3-month follow-up, 12-month follow-uSecondary outcomes
1
Patient Health Questionnaire-9 (PHQ-9)
The Patient Health Questionnaire-9 (PHQ-9) is a 9-item validated self-report measure of depressive symptom severity over the past two weeks. Scores range from 0-27, with higher scores indicating more severe depressive symptoms.
Time frame
Pre-treatment (baseline; one week before treatment start) mid-treatment A (the day after therapy session 4), mid-treatment B (The day after therapy session 7), post-treatment (one week after the last therapy sessio), 3-month follow-up, 12-month follow-up2
Generalized Anxiety Disorder Scale-Revised (GADS-R)
The Generalized Anxiety Disorder Scale-Revised (GADS-R) is a self report questionaire assessing cognitive and behavioral symptoms of generalized anxiety disorder. The scale measures worry severety and maladaptive coping strategies on a 9-point Likert scale (0-8), while metacognitive beliefs about worry are rated on a 0-100 scale. Higher scores indicate greater symptom severity. Secondary outcomes include change in GADS-R score from pre-treatment (baseline) to post-treatment, as well as repeated GADS-R assessments administered during treatment (prior to each therapy session) and at 3-month and 12-month follow-up, to monitor clinical change over time.
Time frame
Pre-treatment (baseline; one week before treatment start) , one day before each therapy session session, post-treatment (one week after last therapy session), 3-month follow-up, 12-month follow-up.3
Work and Social Adjustment Scale (WSAS)
The Work and Social Adjustment Scale (WSAS) is a 5-item self-report questionnaire assessing functional impairment in work, home management, social leisure, private leisure, and close relationships. Scores range from 0-40, with higher scores indicating greater impairment. Secondary outcomes include change in WSAS score from pre-treatment (baseline) to post-treatment (one week after the last therapy session), as well as WSAS scores at 3-month and 12-month follow-up.
Time frame
Pre-treatment (baseline; one week before treatment start) post-treatment (one week after the last therapy session), 3-month follow-up, and 12-month follow-up4
Metacognitions Questionnaire- 30 (MCQ-30)
The Metacognitions Questionnaire- 30 (MCQ-30) is a 30-item self-report measure assessing maladaptive metacognitive beliefs across five domains.Total scores range from 30 to 120, with higher scores indicating stronger dysfunctional metacognitive beliefs.
Time frame
Pre-treatment (baseline; one week before treatment start), post-treatment (one week after the last therapy session), 3-month follow-up, and 12-month follow-upSponsors and contacts
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Source ClinicalTrials.gov