Learning Objective

After reading this article, you should be able to:

1. Evaluate how Metacognitive Reflection and Insight Therapy (MERIT) impacts self-awareness and symptom management in patients with schizophrenia.

REVIEW OF: Hasson-Ohayon I et al, Psychol Psychother 2023 Online ahead of print

STUDY TYPE: Randomized controlled trial

People with schizophrenia often struggle with self-awareness and understanding their own behaviors, as well as those of others. This is referred to as "metacognition." A new therapeutic approach, called Metacognitive Reflection and Insight Therapy (MERIT), aims to enhance this self-awareness. By helping patients reflect on challenges and potential solutions, MERIT supports patients in better understanding themselves and those around them. MERIT adopts a less structured approach to treatment, with a greater focus on patient autonomy and experience compared to common directive therapies for schizophrenia.

The study aimed to see if by improving self-awareness using MERIT, patients' symptoms, social interactions, and overall life quality could also be improved. Researchers worked with 54 patients with schizophrenia, averaging around 40 years old, mostly single, and female. These individuals were divided into two groups: one received MERIT immediately, and the other began therapy after a 6-month wait. All were on antipsychotic medication and were receiving community rehabilitation services.

Progress was measured using a few standardized tests, including the Indiana Psychiatric Illness Interview, the Positive and Negative Syndrome Scale, and the Metacognition Assessment Scale-Abbreviated. Results indicated that nearly 30% of those who completed MERIT saw significant improvements in self-awareness, and about 60% showed progress in at least one area of metacognition. Interestingly, the group that waited for treatment seemed to show a slight increase in symptom severity, while the immediate treatment group's symptoms remained stable.

CARLAT TAKE

Consider using MERIT for patients with schizophrenia. It seems to help in either improving or stabilizing the symptoms. With the need for effective psychological treatments that focus on social interaction and self-reflection, MERIT appears to be a step in the right direction.

APA CITATION

Hasson-Ohayon I, Igra L, Lavi-Rotenberg A, Goldzweig G, Lysaker PH. Findings from a randomized controlled trial of Metacognitive Reflection and Insight Therapy for people with schizophrenia: Effects on metacognition and symptoms [published online ahead of print, 2023 Jul 31]. Psychol Psychother. 2023;10.1111/papt.12485. doi:10.1111/papt.12485.