Targeting Beliefs About Emotions via Meta-Emotion Therapy for Adolescents with Anxiety: A Case Series Study

Research suggests that best-practice psychotherapies only have moderate effects on reducing anxiety in youths. Such limitations in outcomes prompt consideration of alternative conceptualisations of anxiety and its treatment. Based upon the metacognitive model, we propose a novel therapy targeting metacognitive knowledge (beliefs about emotions and emotion regulation) for the treatment of anxiety in adolescents. The current case series study aimed to provide a proof of concept for the effectiveness of Meta-Emotion Therapy for adolescents (MET-A) for the treatment of adolescent anxiety. Four adolescents with elevated anxiety participated in this case series study. All participants received 10 individual sessions of MET-A. Participants and a parent completed the Revised Children’s Anxiety and Depression Scale at baseline, weekly and at one-month follow-up. The participants also completed the Beliefs About Emotions Questionnaire and the Difficulties with Emotion Regulation Scale at baseline, post-therapy and one-month follow-up. The results showed that all participants improved or recovered from symptoms of anxiety and depression from pre- to post-treatment, when taking into consideration both self- and parent-reported ratings (however, these ratings were often non-concordant). Gains were maintained at one-month follow-up. Further, participants who self-reported reductions in anxiety and depression also cited reductions in several maladaptive beliefs about emotions and improvements in aspects of emotion regulation. The participants endorsed the therapy as highly acceptable, appropriate, and feasible. Overall, the results of this study provide preliminary proof of concept for MET-A as a promising intervention for the treatment of adolescent anxiety Further investigation of MET-A is warranted to optimise treatment outcomes and measurement of change.

Clinical Trial Registration: Registered with the Australian and New Zealand Clinical Trial Registry number 382327.