International Journal of Cognitive Therapy, 2(2), 152–159, 2009 © 2009 International Association for Cognitive Psychotherapy 152 NORDAHL EFECTIVENESS OF MCT IN AN OUTPATIENT SETTING Effectiveness of Brief Metacognitive Therapy versus Cognitive-Behavioral Therapy in a General Outpatient Setting Hans M. Nordahl NTNU Trondheim and Department of Psychiatry, Levanger Hospital This study aimed to assess the effectiveness of brief metacognitive therapy when applied to a representative sample of treatment resistant patients in a clinic setting. Patients were typically heterogenous with a range of comorbid diagnoses and the majority had failed to respond to medication. They were randomly assigned to treatment as usual (n = 13; TAU), or metacognitive therapy (n = 15; MCT). TAU consisted of cognitive-behavior therapy. Improvements in depression, anxiety, and worry were observed in both treatments. Patients receiving MCT showed sig- nificantly greater levels of improvement in anxiety and worry than those receiving TAU. It is tentatively concluded that MCT can be safely and effectively delivered as a brief treatment in a heterogenous clinical practice setting. Cognitive behavioral therapy is a well-supported evidence-based treatment for anxiety, depression, and other psychological disorders (Butler, Chapman, Forman, & Beck, 2006). CBT has become the recommended practice for the treatment of anxiety and depression in health-care systems (e.g., National Institute of Clinical Excellence, 2004) and constitutes a common treatment now offered in mental healthcare settings. In recent years there have been new forms of CBT developed and alternative ap- proaches that show varying degrees of commonality with earlier methods based on the principles of Beck and colleagues (Beck, Rush, Shaw, & Emery, 1979). These newer approaches include Mindfulness based cognitive therapy (Segal, Williams, & Teasdale, 2002), Acceptance and Commitment Therapy (Hayes, Strosahl, & Wilson, 1999) and Metacognitive Therapy (Wells, 1995). So far, few studies have examined the effectiveness and safety of these treatments in the heterogenous patient samples normally treated in community mental health settings. The present study aimed to assess the effects of metacognitive therapy in this The author is grateful for the assistance by the following in the various phases of this study: L. Ericksen, P. Vestrum, B.B. Nielsen and G. Kvalsund. Thanks also to Adrian Wells and the reviewers for valuable com- ments on the manuscript. Address correspondence to Hans M Nordahl, Department of Psychology, NTNU, Dragvoll, Trondheim, Norway. E-mail: Hans.Nordahl@SVT.NTNU.NO