Table 1 Overview of metacognitive therapy (MCT; [39]; based on [44]) and exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD)

1

- Provide treatment overview

1–2

- Provide treatment overview

1–3

- Psycho-education about the metacognitive model of OCD

- Psycho-education about the behavioral model of OCD

- Elicit metacognitions by guided questioning

- Generation of a hierarchy of anxiety-provoking situations and avoidance behaviors

- Practicing of detached mindfulness

2

- Modifying metacognitions about intrusions by verbal methods (e.g. questioning the evidence) and behavioral experiments (e.g. exposure with response commission, ritual postponement, and exposure and response prevention experiments)

3–8

- Exposure and response prevention exercises, both within-session and between sessions

4–13

3

- Modifying metacognitions about the necessity of rituals by verbal methods (e.g. questioning the evidence, advantages–disadvantages analysis of performing rituals) and behavioral experiments (e.g. ritual modulation experiments)

9–12

- Generation of a treatment summary consisting of an overview of OCD complaints pretreatment, rest symptoms at post-treatment, and a relapse prevention plan containing helpful interventions to maintain

14–15

4

Generation of a new plan for processing in response to unwanted thoughts, feelings, or events and a therapy blueprint consisting of the case conceptualization, a list of metacognitive beliefs and an overview of evidence challenging them

13–15