Abstract
Metacognition comprises a spectrum of mental activities involving thinking about thinking. Metacognitive impairments may sustain and trigger negative symptoms in people with schizophrenia. Without complex ideas of the self and others, there may be less reason to pursue goal-directed activities and less ability to construct meaning in daily activities, leading to the experience of negative symptoms. As these symptoms tend to be nonresponsive to pharmacotherapy and other kinds of treatment metacognition might be a novel treatment target; improvement of metacognition might lead to improvements in negative symptoms. One therapy that seeks to promote metacognition is the Metacognitive Reflection and Insight Therapy (MERIT). In this study, a case is presented in which a first episode patient with severe negative symptoms is treated with MERIT. A case illustration and the eight core principles of MERIT are presented. Independent assessments of metacognition and negative symptoms before and after therapy show a significant increase of metacognition and decrease of negative symptoms over the course of 40 weeks.
Highlights
Metacognition is a psychological function that comprises a spectrum of mental activities involving thinking about thinking
Without complex ideas of the self and others, there may be less reason to pursue goaldirected activities and less ability to construct meaning in daily activities, leading to the experience of negative symptoms. As these symptoms tend to be nonresponsive to pharmacotherapy and other kinds of treatment metacognition might be a novel treatment target; improvement of metacognition might lead to improvements in negative symptoms
A case is presented in which a first episode patient with severe negative symptoms is treated with Metacognitive Reflection and Insight Therapy (MERIT)
Summary
Metacognition is a psychological function that comprises a spectrum of mental activities involving thinking about thinking. The present study concerns a case in which a first-episode patient with severe negative symptoms is treated with the Metacognitive Reflection and Insight Therapy. This made Ann feel comfortable, the therapist felt like their conversations remained within the socially acceptable realm and no substantial topics regarding what was on Ann’s mind were discussed.
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