In-Congress Workshop 19 - CANCELED- Metacognitive Therapy for Health Anxiety

Health anxiety is a pervasive condition in which people become preoccupied with the possibility of having or developing a serious illness. Cognitive behavioural therapy remains the most evaluated psychological approach, yet systematic reviews and meta-analyses report mixed outcomes for both symptom reduction and long-term relapse. This has created a need for interventions that more directly target the processes that drive health-anxiety persistence and are feasible to deliver in routine services.
The metacognitive model provides that alternative. It frames health anxiety as a disorder maintained by the cognitive-attentional syndrome: worry, checking, internal threat monitoring, and coping behaviours shaped by positive and negative metacognitive beliefs. Research using this model shows that shifting these metacognitions produces substantial and lasting improvement, and that change can occur without discussing the content of illness thoughts. This includes reducing disease conviction, curbing reassurance-seeking, and altering attentional biases without sliding into illness-focused debate — a common drift point in standard CBT.
In this workshop, the metacognitive model of health anxiety will be outlined and used to show how case conceptualisation and treatment can be organised around it. The session will focus on core MCT methods that interrupt the cognitive-attentional syndrome: detached mindfulness, health-worry postponement, attentional modification, and strategies for preventing immersion in the content of health-related thoughts.
We will also examine the metacognitions repeatedly identified as drivers of persistence and relapse. These include beliefs about biased thinking, beliefs that worry is protective, and the paradoxical way that feeling temporarily better can trigger renewed checking or internal monitoring. Understanding these mechanisms gives clinicians the leverage to intervene at the level that actually maintains health anxiety.