In this article the authors present a method and a scale for the evaluation of the metacognitive profiles of psychotherapy patients. There will be a description of the metacognitive function and of the alterations that occur to it during treatment. Various hypotheses will then be considered: (1) that the metacognitive function has a modular structure; (2) that for each type of psychopathological condition there is a different metacognitive deficit profile; (3) that to be successful psychotherapy needs to involve an improvement in any deficient metacognitive sub-function. There will then be a presentation of the Metacognition Assessment Scale (MAS) for the assessment of metacognitive deficits during psychotherapy. We shall then describe the first results we have on the application of the scale. Finally there will be an analysis of two patients suffering from Personality Disorders and a demonstration of what metacognitive deficit profile each one has and how it is modified over the course of psychotherapy treatment. The article ends with a discussion of the hypotheses made at the start in the light of the results that have emerged.

Deficits in metacognition within the narratives of persons with schizophrenia are linked with symptoms, quality of life, neurocognition and poorer awareness of illness.

Our era is witnessing an increasing impact of globalization on self and identity and at the same time a growing uncertainty. The experience of uncertainty motivates individuals and groups to find local niches for identity construction. This article's central tenet is that the processes of globalization and localization, as globalization's counterforce, require a dialogical conceptualization of self and identity in which global and local voices are involved in continuous interchanges and negotiations. This tenet is elaborated along 2 lines of argument. First, 3 factors are described as crucial to understanding the processes of globalization and localization on the individual level: the increasing number of voices and countervoices, the role of social power, and the role of emotions. Second, the authors argue that the apparent tension between the widening horizons of globalization and the need for local niches requires acknowledgment of the pervasive influence of biologically based needs for stability, safety, and security. Finally, the authors propose studying self and identity on 3 levels—individual, local, and global—and some lines of research at the interface of these levels.

Patients' specific personality pathologies are associated with consistent emotional responses, which suggests that clinicians can make diagnostic and therapeutic use of their responses to patients.

Models of schizophrenia, which focus exclusively on discrete symptoms and neurocognitive deficits, risk missing the possibility that a core feature of the disorder involves a reduced capacity to construct complex and integrated representations of self and others. This column details a new methodology that has been used to assess deficits in the metacognitive abilities that allow persons to form complex ideas about themselves and others and to use that knowledge to respond to psychosocial challenges in schizophrenia. Evidence is summarized supporting the reliability and validity of this method, as well as links this work has revealed between metacognition and psychosocial outcomes. It is suggested that this work points to the need to develop interventions which move beyond addressing symptoms and specific skills, and assist persons to recapture lost or atrophied metacognitive capacity and so form the kind of ideas about themselves and others needed, to move meaningfully toward recovery.

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The coronavirus COVID-19 and the global pandemic has already had a substantial disruptive impact on society, posing major challenges to the provision of mental health services in a time of crisis, and carrying the spectre of an increased burden to mental health, both in terms of existing psychiatric disorder, and emerging psychological distress from the pandemic. In this paper we provide a framework for understanding the key challenges for psychologically informed mental health care during and beyond the pandemic. We identify three groups that can benefit from psychological approaches to mental health, and/or interventions relating to COVID-19. These are (i) healthcare workers engaged in frontline response to the pandemic and their patients; (ii) individuals who will experience the emergence of new mental health distress as a function of being diagnosed with COVID-19, or losing family and loved ones to the illness, or the psychological effects of prolonged social distancing; and (iii) individuals with existing mental health conditions who are either diagnosed with COVID-19 or whose experience of social distancing exacerbates existing vulnerabilities. Drawing on existing literature and our own experience of adapting treatments to the crisis we suggest a number of salient points to consider in identifying risks and offering support to all three groups. We also offer a number of practical and technical considerations for working psychotherapeutically with existing patients where COVID-19 restrictions have forced a move to online or technologically mediated delivery of psychological interventions.