Metacognitive Reflection and Insight Therapy for Early Psychosis: A preliminary study of a novel integrative psychotherapy

Vohs, Jenifer L.; Leonhardt, Bethany L.; James, Alison V.; Francis, Michael; Breier, Alan; Mehdiyoun, Nicole F.; Visco, Andrew; Lysaker, Paul H.

doi:10.1016/j.schres.2017.10.041

Cited by 90 publications

(90 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One study (Vohs et al, ) compared MERIT for the treatment of patients with early phase psychosis (MERIT‐EP) with standard treatment. Results showed that MERIT‐EP did not improve symptoms to a greater extent than standard treatment at the end of intervention (Table ).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Philipp

Kriston

Lanio

et al. 2018

Clin Psychology and Psychoth

View full text Add to dashboard Cite

We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random‐effects meta‐analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = −0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = −0.31). MCTrain was more effective than standard treatment in patients with obsessive–compulsive disorder (SMD = −0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = −2.80), posttraumatic stress disorder (SMD = −2.36), and psychological treatments (cognitive–behavioural) in patients with anxiety (SMD = −0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive–behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add‐on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy.

show abstract

Section: Resultsmentioning

confidence: 99%

Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Philipp

Kriston

Lanio

et al. 2018

Clin Psychology and Psychoth

View full text Add to dashboard Cite

show abstract

“…Vohs et al 190 recruited patients with first-episode psychosis with poor clinical insight and randomly assigned them to receive six months of MERIT vs. treatment as usual. Treatment completion rate was 80%.…”

Section: Metacognitively Oriented Integrative Psychotherapy Can Affecmentioning

confidence: 99%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

Self Cite

View full text Add to dashboard Cite

Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

show abstract

“…Eight of the 10 participants assigned to MERIT completed the treatment and significant improvements in clinical insight were found in this group compared to the treatment as usual group at the completion of the trial. 50 In a second trial for a broader variety or patients diagnosed with schizophrenia, 18 of 26 participants completed an 8-month course of treatment with measurable gains detected in the metacognitive domains of self-reflectivity and mastery. 51 Subsequent analysis of this study revealed that higher levels of clinical insight at baseline were associated with greater metacognitive gains.…”

Section: Clinical Trialsmentioning

confidence: 99%

<p>Metacognitive Reflection and Insight Therapy: A Recovery-Oriented Treatment Approach for Psychosis</p>

Lysaker¹,

Gagen²,

Klion

et al. 2020

PRBM

View full text Add to dashboard Cite

Recent research has suggested that recovery from psychosis is a complex process that involves recapturing a coherent sense of self and personal agency. This poses important challenges to existing treatment models. While current evidence-based practices are designed to ameliorate symptoms and skill deficits, they are less able to address issues of subjectivity and self-experience. In this paper, we present Metacognitive Insight and Reflection Therapy (MERIT), a treatment approach that is explicitly concerned with self-experience in psychosis. This approach uses the term metacognition to describe those cognitive processes that underpin self-experience and posits that addressing metacognitive deficits will aid persons diagnosed with psychosis in making sense of the challenges they face and deciding how to effectively manage them. This review will first explore the conceptualization of psychosis as the interruption of a life and how persons experience themselves, and then discuss in more depth the construct of metacognition. We will next examine the background, practices and evidence supporting MERIT. This will be followed by a discussion of how MERIT overlaps with other emerging treatments as well as how it differs. MERIT's capacity to engage patients who reject the idea that they have mental illness as well as cope with entrenched illness identities is highlighted. Finally, limitations and directions for future research are discussed.

show abstract

Metacognitive Reflection and Insight Therapy for Early Psychosis: A preliminary study of a novel integrative psychotherapy

Cited by 90 publications

References 39 publications

Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

<p>Metacognitive Reflection and Insight Therapy: A Recovery-Oriented Treatment Approach for Psychosis</p>

Contact Info

Product

Resources

About