Recovery-Focused Metacognitive Interpersonal Therapy (MIT) for Adolescents with First-Episode Psychosis

Abstract

Access to evidence-based early intervention for adolescents with psychosis is critically important.The aim of this work was analysing the feasibility, acceptability and potential effects of a psychological intervention based on metacognitive interpersonal therapy (MIT) in adolescents presenting with early psychosis. Twenty-three participants (aged 14-18) experiencing first-episode psychosis or an at-risk mental state for psychosis were offered up to 40 hours of individual MIT over a 12-month period. Effect sizes were calculated for changes in subjective recovery experience (primary outcome), psychotic symptoms (secondary outcome), and metacognition (hypothetical mechanism of change) from baseline to treatment end. At study completion, 21 out of 23 (91.3%) participants had received twelve or more sessions of MIT. The average number of MIT treatment sessions received was 31 (range 12-40). Large effect sizes were observed for changes in subjective recovery, self-reflectivity, understanding others' minds, mastery, and emotional distress. Medium effect sizes were observed for changes in negative, positive, and disorganized symptoms. This is the first study to suggest that MIT is both acceptable to young people experiencing early psychosis and is associated with improvements in subjective recovery, symptoms, and metacognition. Despite study limitations, evidence of MIT feasibility, acceptability and potential effects was sufficient to warrant further investigation.

Assessing psychotic spectrum disorders in partnership with patients: Three culturally responsive therapeutic assessment cases.

“…In this way, the very factors that had been pathologized resulting in a PSD misdiagnosis initially, were able to be honored by the patient and the assessing psychologist at the conclusion of the TA. These changes are in line with meta-analytical findings that TA improves patient "self-enhancement" (i.e., self-understanding, self-esteem, and selfconfidence; Durosini & Aschieri, 2021), and importantly, are in keeping with the expected outcomes (i.e., self-reflectivity, subjective recovery) of some recovery-oriented interventions for PSDs (Inchausti et al, 2023).…”

Investigating the relationship between negative symptoms and metacognitive functioning in psychosis: An individual participant data meta‐analysis

“…Future research should explore stratified negative symptom samples using agreed recommendations to differentiate negative symptom experiences (Galderisi et al, 2021). If these relationships can be better modelled in samples with more severe negative symptoms, the symptom profiles best suited to metacognitive treatments, such as metacognitive and reflective insight therapy (Lysaker, Gagen, et al, 2020), metacognitive interpersonal therapy (Inchausti et al, 2023) or metacognitive oriented social skills training (Inchausti et al, 2019), may be better identified.…”

Working through the body in metacognitive interpersonal therapy to change relational patterns in dependent personality disorder: The case of Lia

“…MIT is a third-wave integrative psychotherapy, specifically designed to treat personality disorders (PD) (Dimaggio et al, 2007(Dimaggio et al, , 2015(Dimaggio et al, , 2020. There is growing evidence of the effectiveness of MIT in treating PD in both individual and group therapy (Dimaggio et al, 2017;Gordon-King et al, 2018;Inchausti et al, 2023;Simonsen et al, 2022;Popolo et al, 2018Popolo et al, , 2019Popolo et al, , 2022. These studies demonstrated robust treatment adherence and therapeutic improvements in symptoms, social functioning, and ability to reflect on mental states.…”