Cognitive Therapy and Research

, Volume 39, Issue 1, pp 70–80 | Cite as

Metacognitive Therapy Versus Prolonged Exposure in Adults with Chronic Post-traumatic Stress Disorder: A Parallel Randomized Controlled Trial

  • Adrian WellsEmail author
  • Deborah Walton
  • Karina Lovell
  • Dawn Proctor
Original Article


A parallel randomized controlled trial compared metacognitive therapy (MCT) with prolonged exposure (PE) in 32 patients with PTSD of ≥3 months duration. Participants were assigned to; eight sessions of therapy (MCT or PE) or an 8-week wait period (WL). There was only one drop-out from each treatment. Both active treatments were effective, resulting in significantly lower symptoms of PTSD, anxiety and depression compared with the WL. At post-treatment MCT was superior to PE on self-report symptoms of PTSD and superior to WL on objective measures of hyper-arousal (heart-rate). Recovery rates and reliable improvement in both MCT and PE were high. MCT exerted effects more rapidly and within group effect sizes in MCT were much larger than those in PE at the end of treatment. Clinical gains remained evident at follow-up by which time the treated groups did not differ. In conclusion; both treatments were effective but MCT had a clear advantage. The clinical implications and suggestions for future research are discussed.


Posttraumatic stress disorder Clinical trials Cognitive-behavior therapy Metacognitive therapy Prolonged exposure 


Conflict of Interest

Adrian Wells, Deborah Walton, Karina Lovell and Dawn Proctor declared that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards 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 before 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

  • Adrian Wells
    • 1
    • 2
    • 3
    Email author
  • Deborah Walton
    • 1
  • Karina Lovell
    • 4
  • Dawn Proctor
    • 1
  1. 1.School of Psychological SciencesUniversity of ManchesterManchesterUK
  2. 2.Manchester Mental Health NHS Social Care TrustManchesterUK
  3. 3.Department of PsychologyNTNUTrondheimNorway
  4. 4.School of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK

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