Cognitive Therapy and Research

, Volume 39, Issue 1, pp 14–22 | Cite as

Group Metacognitive Therapy for Severe Antidepressant and CBT Resistant Depression: A Baseline-Controlled Trial

  • Costas Papageorgiou
  • Adrian Wells
Original Article


A significant proportion of individuals experience treatment-resistant depression, defined as a lack of or limited response to current recommended treatments. This study evaluated the effectiveness of group metacognitive therapy (GMCT) for patients who had not responded to both antidepressants and cognitive-behaviour therapy. Following a no-treatment baseline monitoring period, ten patients received 12 2-h weekly sessions, two post-treatment booster sessions and were followed up at 6 months. All of the patients completed GMCT, suggesting that this treatment was acceptable. GMCT was associated with significant improvements across measures of depression, anxiety, rumination, and positive and negative metacognitive beliefs about rumination. These gains were maintained at follow-up. Analyses of rates of recovery revealed that 70 % of patients were classified as recovered and a further 20 % as improved at both post-treatment and 6 months follow-up. There were also reductions in the frequency of comorbid diagnoses. This preliminary study supports further research into GMCT for treatment-resistant depression as a potential clinical and cost effective intervention.


Treatment-resistant depression Antidepressant Cognitive-behaviour therapy Metacognitive therapy Group therapy 


Conflict of Interest

Costas Papageorgiou and Adrian Wells declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standard of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Animal Rights

No animal studies were carried out by the authors for this article.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.The Priory Hospital AltrinchamHale, CheshireUK
  2. 2.The University of ManchesterManchesterUK

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