Using the back door: metacognitive training for psychosis.
Abstract
Delusions have traditionally been considered impervious to counter-arguments and thus not amenable to psychotherapy. However, a growing body of evidence from Cognitive Behavior Therapy for psychosis (CBT-p) has indicated that challenging the delusional beliefs may be effective in reducing their severity. Metacognitive Training/Therapy (MCT) for psychosis also targets delusions, using a back door approach by helping clients gain insight into the cognitive biases behind delusions, followed by attempts to plant the seeds of doubt, and weaken delusional beliefs. There are two variants of MCT, the group format MCT and the individual therapy format MCT (i.e. MCT+). The MCT intervention has three components: (a) normalization, (b) facilitating insight into the relationship between cognitive biases and delusions, and (c) sowing the seeds of doubt in delusional beliefs. Among these, the first two components are common to both MCT and MCT+, whereas the third is specific to MCT+. Initial findings about the effects of MCT in reducing the delusional convictions are encouraging. The present article elaborates on the theoretical background, process, clinical implications, empirical status, and the advantages and limitations of this intervention.
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MCT promotes cognitive flexibility by raising metacognitive awareness and knowledge for cognitive biases and reduces positive symptoms.
“MCT on the other hand aims to promote patients’ cognitive flexibility by raising metacognitive awareness and knowledge for cognitive biases (21) and showed significant effects on reducing positive symptoms (8, 22, 23).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [22]
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- Authors
- Kumar, D., Menon, M., Moritz, S., & Woodward, T. S.
- Affiliations
- National Institute of Mental Health and Neurosciences (IN)
- University of British Columbia (CA)
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Kumar, Devvarta
- Venue
- Psychosis
- Publisher
- Informa UK Limited
- Published
- 2014-06-06
- Volume
- 7
- Issue
- 2
- Pages
- 166-178
- ISSN
- 1752-2439 (ISSN-L)
- 1752-2447
- OpenAlex
- W2103077226
- Cited by
- 20
- References
- 41
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 4 · 2018: 1 · 2016: 3 · 2015: 5
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosis (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- metacognitive training, delusions, cognitive biases, normalization, group therapy, individual psychotherapy
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