Managing worrying about worrying with metacognitive restructuring versus metacognitive defusion
Zettle, Robert D. Quan, Huan Larson, Jonathan M.
Zettle, Robert D.
Quan, Huan
Larson, Jonathan M.
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Issue Date
2026-04-16
Type
Article
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Keywords
Generalized anxiety disorder,Metacognitive defusion,Metacognitive restructuring,Process-based cognitive behavioral therapy
Subjects (LCSH)
Citation
Zettle, R. D., Quan, H., & Larson, J. M. (2026). Managing Worrying About Worrying with Metacognitive Restructuring Versus Metacognitive Defusion. Behavioral Sciences, 16(4), 594. https://doi.org/10.3390/bs16040594
Abstract
Process-based cognitive behavioral therapy (PB-CBT) seeks to identify kernels that are equally efficacious in treating various disorders. While both metacognitive therapy (MCT) and acceptance and commitment therapy (ACT) represent evidence-based interventions for generalized anxiety disorder (GAD), it remains unclear if there are specific components within each that are comparable in managing meta-worrying characteristic of GAD. A subclinical sample of college students received a brief session targeting a single, personally relevant meta-worry of either metacognitive restructuring as practiced in MCT or an extension of ACT defusion exercises. Both were equally effective in impacting believability, distress, and willingness ratings of the targeted worry as well as untargeted worries. However, significantly longer metacognitive defusion sessions suggest that metacognitive restructuring may represent a more cost-effective option. Levels of generalized anxiety, dispositional worrying, and depression did not moderate treatment responsivity. Implications of findings for PB-CBT research and practice are discussed within the context of study limitations. © 2026 by the authors.
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Description
This is an open access article under the CC BY license.
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Journal
Behavioral Sciences
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Digital Collection
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PubMed ID
ISSN
2076328X