The Brief Intervention Effect of Metaphorical Cognitive Restructuring on Alleviating Mental Distress: A Randomised Controlled Experiment.

Background: Metaphors may provide clarity or identify hidden similarities between two ideas, and their use in cognitive restructuring can help maximise the effect of therapy information. This study aimed to determine whether metaphorical cognitive restructuring would produce a greater intervention effect in targeted mood and cognition than non-metaphorical restructuring.

Methods: Eighty-eight participants chose 25 problems of interest and wrote a self-report distress problem and were then randomly divided into a metaphorical restructuring group (N = 29), a literal restructuring group (N = 30), or a no restructuring problem restating group (N = 29). Participants first read a description of psychological distress ("problem") and then read a solution within one micro-counseling scenario. They were asked to evaluate their insightfulness during the intervention and evaluated mental distress and self-efficacy before and after the intervention.

Results: The mental distress of the metaphorical restructuring group significantly decreased after the intervention. Further, this group had greater insightfulness during the intervention, and this insightfulness could predict the reduction of negative affect after the intervention.

Conclusions: The use of metaphors can be of great value in eliciting a salient cognitive restructuring process and in alleviating mental distress.