Wells’ published protocol asks for two practice sessions a day, about twelve minutes each[1]. That is the reference dose from the treatment manual; in the research literature the actual amount practiced varies widely, from a single laboratory session to weeks of daily home practice. Across all of it, the working assumption is the same: the benefit of attention training is framed around regular repetition, not occasional long sessions.
What the manual says
The 2009 treatment manual is specific: patients are asked to practice twice a day, with practice scheduled for approximately twelve minutes[1]. The session itself is fixed in shape — about five minutes of selective attention, five of rapid switching, and two of divided attention[1] — so frequency, not session design, is the main thing left to the practitioner.
Wells also designed the exercise to stay demanding over time, with sounds and layouts varied between sessions so practice doesn’t make the task easy[1]. Repetition is the point; habituation is designed against.
What studies actually did
| Study | Practice amount |
|---|---|
| Rosenbaum et al. 2018[2] | A single session, in the lab |
| Knowles & Wells 2018[3] | A single ~12-minute dose, randomized comparison |
| Barth et al. 2019[4] | Two or four plays of the ATT audio (“doses”) — one ~23-minute session held two, so groups trained on one or two consecutive days |
| Carter & Wells 2018[5] | Asked for two to three practices daily; typical compliance was twice a day |
Two things stand out. Laboratory studies show measurable within-session effects from even a single dose[2] [3] — and clinical use still asks for sustained daily practice[1] [5]. No study has directly compared practice schedules to find an optimal dose; twice daily is the manual’s prescription, not an experimentally derived minimum.
If you practice less
You’d be the norm, not the exception: Wells’ manual itself notes that in reality most patients only manage the practice once a day[1]. A once-daily session, or even a few sessions a week, still gives you the thing the technique is built around: repeated, spaced practice at steering attention. Missing days is normal — the exercise is designed to stay demanding, so coming back after a gap doesn’t reset anything; it just feels like the practice always does.
If you keep only one rule, make it small and regular beats long and rare: the protocol’s own logic favors a steady rhythm of short sessions over occasional marathons[1].
Does session length matter?
The published session is about twelve minutes[1], and some laboratory studies ran longer variants (about twenty-three minutes)[4]. Much shorter sessions haven’t really been studied, so there’s no evidence-based answer for “is five minutes enough?” — the honest position is that twelve minutes is the tested shape.
For what happens inside those twelve minutes, see the Attention Training Technique explained.
References
- Wells, A. (2009). Metacognitive Therapy for Anxiety and Depression. Guilford Press. Chapter 4: Attention Training Techniques.
- Rosenbaum, D., Maier, M. J., Hudak, J., Metzger, F. G., Wells, A., Fallgatter, A. J., & Ehlis, A.-C. (2018). Neurophysiological correlates of the attention training technique: A component study. NeuroImage: Clinical, 19, 1018–1024. https://pmc.ncbi.nlm.nih.gov/articles/PMC6039840/
- Knowles, M. M., & Wells, A. (2018). Single dose of the attention training technique increases resting alpha and beta-oscillations in frontoparietal brain networks: A randomized controlled comparison. Frontiers in Psychology, 9, 1768. https://pmc.ncbi.nlm.nih.gov/articles/PMC6158576/
- Barth, V., Heitland, I., Krüger, T. H. C., Kahl, K. G., Sinke, C., & Winter, L. (2019). Shifting instead of drifting – Improving attentional performance by means of the attention training technique. Frontiers in Psychology, 10, 23. https://pmc.ncbi.nlm.nih.gov/articles/PMC6351493/
- Carter, K. E. P., & Wells, A. (2018). Effects of the attention training technique on auditory hallucinations in schizo-affective disorder: A single case study. Case Reports in Psychiatry, 2018, 1537237. https://pmc.ncbi.nlm.nih.gov/articles/PMC6106726/
Published by the makers of Heed, an iPhone app for practicing ATT-style sessions. Heed is a self-practice tool inspired by ATT research — not therapy, and not a medical device.