The HMT manual

Okay friends, if you haven’t already guessed this was a bit of fun for April 1st. We don’t think we will be doing a real HMT manual any time soon 😉

The Heavy Metal Therapy Manual

There’s a therapy for everything these days, right?  But no therapy is real without a manual to accompany it, so here we can talk you through everything you need to do, on a step by step basis to deliver this creative approach, without having to use any of your own creativity (or any other part of your brain) – therapists can simply follow the steps to get those unhappy metalheads moshing again.

Outcome Measures

Conduct outcome measures at every opportunity, every 30 seconds if possible, the scores will be used for our RCT so these are the most important part of the whole therapy.  We are using the Mosh6 (below), that no one else knows about but we wrote a paper on it once and want loads of citations.  A change score of at least 3 points is significant, and we are also interested in people going from the ‘officially miserable’ clinical range, to the more acceptable ‘a bit goth’

*authors note – for more extensive assessment, clinicians should consider using the MOS-H long form version of 666 items.


Delivered via zoom moshpit.  Therapists must display absolute adherence to the model as described in this manual, all independent thoughts will be eliminated (via the ‘broken backwards record’ method) to minimise risk of variance.


Session one should be spent screening your metalhead client for suitability.  We will exclude everyone who doesn’t meet the criteria of:

·        Hair length between 30 and 40 cms (to confirm metalhead status)

·        Born on a Tuesday, is called Bob

·        Must never have touched any illegal drugs, or legal drugs, there must be no ‘risk’ as we define it

·        Must be diagnosed with this highly specific thing we want, but not any of the other 300 possible things, and is otherwise completely ‘stable’ mentally, but meets the criteria for mental health services

·        Promises not to do anything weird or have any life events that will affect our results

·        Willing to do 17 hours of homework between the sessions each week

We require 6 million participants to get adequate power for our study, but we will make our criteria so tight we will settle for 11.


Suitable metalheads will be randomly allocated into 2 groups, the experimental condition of ‘moshpit’ and the control group of ‘absolutely fuck all’.  Those in the moshpit group will receive 4.5 sessions of brief but intensive heavy metal therapy, those in the absolutely fuck all condition will be asked to sit completely still on the sofa for the duration of the study except to fill in the outcome measures.

·        Session one – socialising to the model.  Describe an extremely complex 36 component model using a flow chart

·        Session two and three – remind people that they are doing everything wrong so they should stop doing that, that will be set as homework.  Ask them to explain the model in great detail, if they can’t do it they can be excluded from the results.

·        Session four and 4.5 – remind people that they are not doing enough homework and that is why they are not getting better.

Any significant result indicates that just 4.5 sessions of heavy metal therapy can be beneficial for metalheads and will be incorporated into various guidance.  The health service will offer an abridged 3 session version in a group format, allowing workers to increase caseloads to 700 each.

Top Tips

Talk to metalheads as if they are human (and as if you are too), this helps with rapport.  However, do not say anything that is not in the manual

Try to use accessible language that metalheads will understand – we consulted our most compliant expert patient on this, who fortunately agreed with everything we said.  Use words like ‘mosher’, ‘greebo’ and mention that songs ‘slap’ in order to build alliance.

Respect genres – most metalheads are highly sensitive about this.  If you get into any trouble, just say your favourite band is the death metal outfit Nickleback, this will get you out of most situations unscathed.

2 thoughts on “The HMT manual

  1. Well, I’m completely convinced by this methodology. It looks just like every other therapy manual I have ever read, so it must be the truth. I would get out more, but my boots are laced so tight that I can’t walk.


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