The influence of metacognitive training on delusion severity and metacognitive ability in schizophrenia

Abstract

Individualized metacognitive training is an effective therapy for reducing delusion severity and at the same time increasing metacognitive ability. Correlations emerged between delusion severity and metacognitive ability was needed to be established. Current research findings on cognitive biases and their link to schizophrenia/delusions are explained in a comprehensible and non-stigmatizing manner to patients and illustrated by multiple (everyday life) examples. The article is a report of a study conducted to explore the influence of individualized metacognitive therapy (MCT) on delusional severity and metacognitive ability. Delusional beliefs are at the core of schizophrenia. While there is emerging evidence on the usefulness treatment for psychosis of the group training MCT, so far only one study has investigated the effectiveness of individualized metacognitive training. A quasi experimental approach was adopted: The sample consisted of each 26 patients in the intervention group and in the control group. We found that delusion severity as assessed with the Psychosis Rating Scales and metacognitive abilities using the Metacognitive Ability Questionnaire improved significantly in the intervention group. Group differences achieved significance in favour of the MCT for all measures. Correlations that emerged between delusion severity and metacognitive ability were needed to be established. Metacognitive training appears to be effective in decreasing delusion severity and increasing metacognitive ability. We recommend that individualized MCT for a schizophrenic client should become a standard procedure in the treatment of psychosis, which can be administered by a qualified nurse.

Metacognitive training for delusions (MCTd): effectiveness on data-gathering and belief flexibility in a Chinese sample

“…We found statistically and clinically significant treatment effects in reducing positive symptoms and delusions, which were maintained after 1 month post-treatment. Our large treatment effect sizes for overall symptomatology, delusional severity and conviction were larger or comparable with previous MCT based studies (Moritz et al, 2011b; Erawati et al, 2014; Garety et al, 2014; Waller et al, 2015). MCTd was half the duration of the original MCT, and 40% the duration of the individualized MCT+ for psychosis.…”

Disclosure of researcher allegiance in meta-analyses and randomised controlled trials of psychotherapy: a systematic appraisal

“…However, positive effects of treatments were reported by studies without the involvement of the developers or sponsorships. 38 Hence, we have only compared the current reporting of allegiance versus the reporting of any other potential factors that influence a researcher's actions and the reporting of results in the conducted studies, such as COIs and funding sources.…”

Using the back door: Metacognitive training for psychosis

“…It has been found to reduce the delusional conviction and intensity of distress exerted by delusions, with findings typically in the range of medium effect sizes (reflecting MCT group effects over and above control group effects) (Aghotor, Pfueller, Moritz, Weisbrod, & Roesch-Ely, 2010;Erawati et al, 2014;Favrod, Maire, Bardy, Pernier, & Bonsack, 2011;Kumar et al, 2010;Moritz, Kerstan et al, 2011;Moritz et al, 2013). The improvements are also seen in interpersonal and psychosocial functioning domains Moritz, Kerstan et al, 2011;Naughton et al, 2012).…”

“…Subjectively many individuals report that they had fun while going through this program and that they utilize the information learnt more often; for example, thinking about alternative explanations before judging any person or situation (Erawati et al, 2014;Moritz et al, 2013).…”