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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1461387

Qualitative Analysis of Emotional Distress in Burns, Plastic and Reconstructive Surgery Patients from the Perspectives of Cognitive and Metacognitive Models

Provisionally accepted
Joseph Taylor-Bennett Joseph Taylor-Bennett 1,2Lora Capobianco Lora Capobianco 3Julie Wisely Julie Wisely 2Adrian Wells Adrian Wells 1,3*
  • 1 The University of Manchester, Manchester, England, United Kingdom
  • 2 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
  • 3 Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom

The final, formatted version of the article will be published soon.

    Burns and other injuries requiring plastic and/or reconstructive surgery (BPRS) are life changing, often unexpected, and increase the risk of psychiatric morbidity. There are no published studies we are aware of that explores the applicability of psychological models to BPRS patients. Cognitive behavioural therapy (CBT) is the benchmark treatment in mental health but may be less effective in physical health settings. Metacognitive therapy (MCT) can be more effective than CBT in mental health settings and shows promise in reducing anxiety and depression symptoms in people with cancer and cardiac disease. The present study explored the psychological experiences (feelings, thoughts, and coping strategies) of BPRS patients, and whether the concepts underpinning cognitive and metacognitive models can be elicited from these accounts. Semi-structured interviews were conducted with eleven patients recruited from a BPRS psychology service. Data was analysed using Thematic Analysis. Patients described a range of emotions including low mood, anxiety, anger, guilt, loss and negative thinking. From the perspective of the cognitive model, there were examples of each of ten pre-specified distorted thinking types (cognitive distortions) and patient talk seemed to fit problem-specific cognitive models. From the perspective of the metacognitive model all patients described the 'cognitive attentional syndrome' i.e. how they engaged in repetitive negative thinking (worry, rumination) and thought-focused regulation strategies. Patient talk also demonstrated both positive and negative metacognitive beliefs. The implications of applying the findings from each model to clinical practice are discussed. The metacognitive model may offer benefits in clinical practice that should be investigated further.

    Keywords: Cognitive-behaviour therapy, Metacognitive Therapy, Burns, plastic and reconstructive surgery patients, Emotional distress, qualitative research

    Received: 08 Jul 2024; Accepted: 23 Sep 2024.

    Copyright: © 2024 Taylor-Bennett, Capobianco, Wisely and Wells. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Adrian Wells, The University of Manchester, Manchester, M13 9PL, England, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.