Üstbilişsel Terapi ile Kaygı Belirtilerinin Ele Alınması: Psikolojik Danışmanlık Sürecinde Bir Vaka Çalışması

Yıl 2025, Cilt: 12 Sayı: 3, 545 - 576, 30.09.2025

Umut Aydoğdu , Özlem Tagay

Öz

Bu tek vakaya dayalı çalışmada amaç, yaygın kaygı belirtilerinin ele alınmasında Metabilişsel Kuram Temelli Psikolojik Danışma (MKPD) yaklaşımının etkililiğini incelemektedir. Araştırma, sürekli endişe, kontrol edilemeyen düşünceler ve fizyolojik kaygı semptomları yaşayan 22 yaşındaki bir danışanla yürütülen dokuz oturumluk bireysel psikolojik danışma sürecine dayanmaktadır. Psikolojik danışma süreci, Adrian Wells’in metabilişsel modeline göre yapılandırılmış ve sürecin temel hedefi, danışanın işlevsel olmayan üstbilişsel inançlarını fark etmesi, bu inançları yeniden değerlendirmesi ve daha esnek dikkat stratejileri geliştirmesi olmuştur. Süreç boyunca endişe saati, dikkat eğitimi, ayrışmış farkındalık ve Sokratik sorgulama gibi teknikler kullanılmıştır. Müdahalenin etkililiğini değerlendirmek amacıyla Endişe İnançları Ölçeği ve Beck Anksiyete Envanteri hem ön-test hem de son-test olarak uygulanmıştır. Uygulama sonucunda danışanın hem kaygı düzeyinde hem de metabilişsel inançlarında anlamlı azalmalar gözlenmiştir. Danışan, endişeyi kontrol edilebilir bir zihinsel süreç olarak görmeye başlamış, düşüncelerine karşı daha ayrışmış ve esnek bir yaklaşım geliştirmiştir. Bu bulgular, MKPD yaklaşımının bireysel düzeyde uygulanabilirliğini göstermektedir ancak bulguların genellenebilirliğini test etmek amacıyla daha geniş örneklemlerle yapılan araştırmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

Metakognitif Teori Tabanlı Psikolojik Danışmanlık , Yaygın Kaygı , Danışmanlıkta Vaka Çalışması

Etik Beyan

Araştırma süreci ve raporlamada hiçbir etik taviz verilmemiş, tüm süreç etik ilkelere uygun yürütülmüştür.

Proje Numarası

355

Working with Anxiety Symptoms through Metacognitive Theory in Psychological Counseling: A Case Example

Öz

This single-case study examined the effectiveness of Metacognitive Theory-Based Psychological Counseling (MT-PC) in addressing symptoms of generalized anxiety. The intervention was carried out through nine individual counseling sessions with a 22-year-old client who reported persistent worry, uncontrollable thoughts, and physiological manifestations of anxiety. The counseling process was structured according to Adrian Wells’ metacognitive model and aimed to facilitate the client’s recognition and reevaluation of dysfunctional metacognitive beliefs, as well as the development of more flexible attentional strategies. Throughout the sessions, techniques such as worry postponement, attention training, detached mindfulness, and Socratic dialogue were employed. To assess the intervention's effectiveness, the Worry Beliefs Scale and the Beck Anxiety Inventory were given before and after the intervention. The results revealed significant reductions in both anxiety levels and maladaptive metacognitive beliefs. By the end of the counseling process, the client began to perceive worry as a manageable cognitive process and developed a more detached and flexible approach to intrusive thoughts. These findings suggest that MT-PC may be a viable approach at the individual level in treating generalized anxiety symptoms. However, further research involving larger and more diverse samples is needed to evaluate the generalizability and long-term effectiveness of this approach.

Anahtar Kelimeler

Metacognitive Theory-Based Psychological Counseling , Generalized Anxiety , Case Study in Counseling

Proje Numarası

355

Kaynakça

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Arslan, G., Aydoğdu, U., & Uzun, K. (2025). Longitudinal impact of the ACT-based positive psychology intervention to improve happiness, mental health, and well-being. Psychiatric Quarterly. https://doi.org/10.1007/s11126-025-10145-7
• Aydoğdu, U., & Karataş, Z. (2025). Psikolojik danışman adaylarının psikolojik esneklik ve psikolojik katılıkları. Mehmet Akif Ersoy University Journal of Education Faculty(74), 262-282. https://doi.org/10.21764/maeuefd.1554997
• Aydoğdu, U., & Karataş, Z. (2025). Worry Beliefs Scale: A Scale Development Study. Adıyaman University Journal of Educational Sciences, 15(1), 87-115. https://doi.org/10.17984/adyuebd.1595236
• Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. https://doi.org/10.1037/0022-006X.56.6.893
• Davey, G. C., Hampton, J., Farrell, J., & Davidson, S. (1992). Some characteristics of worrying: Evidence for worrying and anxiety as separate constructs. Personality and Individual Differences, 13(2), 133–147. https://doi.org/10.1016/0191-8869(92)90036-O
• Ehring, T., & Watkins, E. R. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1(3), 192–205. https://doi.org/10.1521/ijct.2008.1.3.192
• Ehring, T., Frank, S., & Ehlers, A. (2008). The role of rumination and reduced concreteness in the maintenance of posttraumatic stress disorder and depression following trauma. Cognitive Therapy and Research, 32(4), 488–506. https://doi.org/10.1007/s10608-006-9089-7
• Ehring, T., Zetsche, U., Weidacker, K., Wahl, K., Schönfeld, S., & Ehlers, A. (2011). The Perseverative Thinking Questionnaire (PTQ): Validation of a content-independent measure of repetitive negative thinking. Journal of Behavior Therapy and Experimental Psychiatry, 42(2), 225–232. https://doi.org/10.1016/j.jbtep.2010.12.003
• Fisher, P. L., & Wells, A. (2008). Metacognitive therapy for obsessive–compulsive disorder: A case series. Journal of Behavior Therapy and Experimental Psychiatry, 39(2), 117–132. https://doi.org/10.1016/j.jbtep.2006.12.001
• Fisher, P., & Wells, A. (2009). Metacognitive therapy: Distinctive features. Routledge. https://doi.org/10.4324/9780203881477
• Gilbert, P. (2001). Evolutionary approaches to psychopathology: The role of natural defences. Australian & New Zealand Journal of Psychiatry, 35(1), 17–27. https://doi.org/10.1046/j.1440-1614.2001.00856.x
• Hammersmark, A. T., Hjemdal, O., Hannisdal, M., Lending, H. D., Reme, S. E., Hodne, K., Osnes, K., Gjengedal, R., & Johnson, S. U. (2024). Metacognitive therapy for generalized anxiety disorders in group: A case study. Journal of Clinical Psychology, 80(4), 884–899 https://doi.org/10.1002/jclp.23615
• Harrington, J. A., & Blankenship, V. (2002). Ruminative thoughts and their relation to depression and anxiety. Journal of Applied Social Psychology, 32(3), 465–485. https://doi.org/10.1111/j.1559-1816.2002.tb00225.x
• Haseth, S., Solem, S., Sørø, G. B., Bjørnstad, E., Grøtte, T., & Fisher, P. (2019). Group metacognitive therapy for generalized anxiety disorder: A pilot feasibility trial. Frontiers in Psychology, 10, 290. https://doi.org/10.3389/fpsyg.2019.00290
• Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
• McEvoy, P. M., Mahoney, A. E., & Moulds, M. L. (2010). Are worry, rumination, and post-event processing one and the same? Development of the Repetitive Thinking Questionnaire. Journal of Anxiety Disorders, 24(5), 509–519. https://doi.org/10.1016/j.janxdis.2010.03.008
• Nordahl, H., Borkovec, T. D., Hagen, R., Kennair, L. E. O., Hjemdal, O., Solem, S., Hansen, B., & Wells, A. (2017). Metacognitive therapy versus cognitive–behavioural therapy in adults with generalised anxiety disorder. The British Journal of Psychiatry, 210(4), 326–332.
• Osmanoğlu, R. M., Tuğyıldız, R. Y., & Koçyiğit, S. (2025). Comparison of acceptance and commitment therapy and metacognitive therapy. Psikoloji Araştırmaları, 2(2), 7–30.
• Papageorgiou, C., & Wells, A. (2000). Treatment of recurrent major depression with attention training. Cognitive and Behavioral Practice, 7(4), 407–413. https://doi.org/10.1016/S1077-7229(00)80051-6
• Rezaei, M., Abbasi, G., & Hadinezhad, P. (2025). Metacognitive therapy for dysfunctional attitudes in generalized anxiety disorder: A controlled study. International Journal of Body, Mind & Culture, 12(1). https://doi.org/10.61838/ijbmc.v12i1.721
• Sadeghi, R., Mokhber, N., Mahmoudi, L. Z., Asgharipour, N., & Seyfi, H. (2015). A systematic review and meta-analysis on controlled treatment trials of metacognitive therapy for anxiety disorders. Journal of Research in Medical Sciences, 20(9), 901–909. https://doi.org/10.4103/1735-1995.170632
• Santos, V. A., & Coutinho, F. (2024). Acceptance and commitment therapy (ACT). In Approaches in Cognitive Behavioral Therapy (pp. 161–178). Springer. https://doi.org/10.1007/978-3-031-63494-9_8
• Solem, S., Hagen, R., Nordahl, H. M., Vogel, P. A., & Wells, A. (2019). Metacognitive therapy for depression: A 3-year follow-up study assessing recovery, relapse, work force participation and quality of life. Frontiers in Psychology, 10, 2908. https://doi.org/10.3389/fpsyg.2019.02908
• Ulusoy, M., Şahin, H. N., & Erkmen, H. (1998). Turkish version of the Beck Anxiety Inventory: Psychometric properties. Journal of Cognitive Psychotherapy: An International Quarterly, 12, 163–172.
• Uzun, K. (2025). Using Yalom’s When Nietzsche Wept to enhance psychological mindedness in future counselors. Counseling Psychologist. https://doi.org/10.1177/00110000251352571
• van der Heiden, C., Melchior, K., & de Stigter, E. (2013). The effectiveness of group metacognitive therapy for generalised anxiety disorder: A pilot study. Journal of Contemporary Psychotherapy, 43(3), 151–157. https://doi.org/10.1007/s10879-013-9235-y
• van der Heiden, C., Muris, P., & van der Molen, H. T. (2012). Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Behaviour Research and Therapy, 50(2), 100–109. https://doi.org/10.1016/j.brat.2011.12.005
• Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23(3), 301–320. https://doi.org/10.1017/S1352465800015897
• Wells, A. (2009). Metacognitive therapy for anxiety and depression. Guilford Press.
• Wells, A. (2013). Advances in metacognitive therapy. International Journal of Cognitive Therapy, 6(2), 186–201. https://doi.org/10.1521/ijct.2013.6.2.186
• Wells, A., & King, P. (2006). Metacognitive therapy for generalized anxiety disorder: An open trial. Journal of Behavior Therapy and Experimental Psychiatry, 37(3), 206–212. https://doi.org/10.1016/j.jbtep.2005.07.002
• Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34(11–12), 881–888. https://doi.org/10.1016/S0005-7967(96)00050-2
• Wells, A., Welford, M., King, P., Papageorgiou, C., Wisely, J., & Mendel, E. (2010). A pilot randomized trial of metacognitive therapy vs applied relaxation in the treatment of adults with generalized anxiety disorder. Behaviour Research and Therapy, 48(5), 429–434. https://doi.org/10.1016/j.brat.2009.11.013