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Metacognition – What did James H. Flavell really say and the implications for the conceptualization and design of metacognitive interventions.
Abstract
In the last two decades years, several interventions have been designed for people with major psychological disorders that all have "metacognitive" in their name: Metacognitive Therapy (MCT), Metacognitive Training (e.g., for people with psychosis) and Metacognitive Reflection and Insight Therapy (MERIT). Two of these interventions are primarily targeted at patients with schizophrenia. Prompted by a recent discussion about what constitutes "true" metacognitive treatment, we will first explore the original concept of metacognition as defined by James H. Flavell. Then, we will describe each approach in detail before highlighting how each intervention picks up on slightly different aspects of Flavell's original metacognitive construct. We will also discuss inherent problems with the label "metacognition."
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“However, authors criticize that existing treatments only cover certain aspects of the larger construct of metacognition (see Supplementary Table 3) (93) and call for intervention development that incorporate all four metacognitive domains into hybrid approaches (104).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [93]
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Sekmek, Ö. S. Ö., Kamış, G. Z., Şenol, B., Erol, Ö. Ö., Ugurlu, M. M., & Göka, E. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06686-7 · Cited by 4
Wiesepape, C. N., Leonhardt, B. L., Hamm, J. A., & Faith, L. A. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1746025 · Cited by 6
The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research
Díaz-Cutraro, L., Verdaguer-Rodríguez, M., Ferrer-Quintero, M., Montserrat, R., Moritz, S., Lysaker, P. H., Dimaggio, G., Palma‐Sevillano, C., Lamarca, M., Espinosa, V., et al. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70223 · Cited by 4
Metacognitive Training to Improve Insight and Work Outcome in Schizophrenia
Zalzala, A. B., Fiszdon, J. M., Moritz, S., Wardwell, P., Petrik, T., Mathews, L. L., Shagan, D. S., Bracken, D., Bell, M. D., Pearlson, G. D., et al. (2022) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001512 · Cited by 4
Cain, L., Strodl, E. S., & Howard, G. (2024) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-023-09605-7 · Cited by 4
Metadata
- Authors
- Moritz, S., & Lysaker, P. H.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Richard L. Roudebush VA Medical Center (US)
- Corresponding author
- Moritz, Steffen
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 201
- Pages
- 20-26
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2808041219
- Cited by
- 187
- References
- 85
- Citations by year
- 2026: 24 · 2025: 15 · 2024: 19 · 2023: 24 · 2022: 23 · 2021: 27 · 2020: 24 · 2019: 20 · 2018: 10
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- metacognition
- MeSH terms
- Metacognition, Humans, Terminology as Topic, Psychological Theory, Schizophrenia, Cognitive Behavioral Therapy
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