Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention.
Abstract
PURPOSE OF REVIEW: There has been a marked increase in the study of cognitive biases in schizophrenia, which has in part been stimulated by encouraging results with cognitive-behavioral interventions in the disorder. We summarize new evidence on cognitive biases thought to trigger or maintain positive symptoms in schizophrenia and present a new therapeutic intervention. RECENT FINDINGS: Recent studies indicate that patients with paranoid schizophrenia jump to conclusions, show attributional biases, share a bias against disconfirmatory evidence, are overconfident in errors, and display problems with theory of mind. Many of these biases precede the psychotic episode and may represent cognitive traits. Building upon this literature, we developed a metacognitive training program that aims to convey scientific knowledge on cognitive biases to patients and provides corrective experiences in an engaging and supportive manner. Two new studies provide preliminary evidence for the feasibility and efficacy of this approach. SUMMARY: The gap between our advanced understanding of cognitive processes in schizophrenia and its application in clinical treatment is increasingly being narrowed. Despite emerging evidence for the feasibility and efficacy of metacognitive training as a stand-alone program, its most powerful application may be in combination with individual cognitive-behavioral therapy.
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Three (17%) utilised Meta Cognitive Therapy (MCT).
“Three (17%) utilised Meta Cognitive Therapy (MCT; Moritz & Woodward, 2007)”
From A systematic review and meta-analysis of cognitive behavioural informed psychological interventions for psychiatric inpatients with psychosis (2020) · cites this paper as Moritz & Woodward, 2007
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 [21]
MCT's goals are implemented in a group therapy format that works with non-confrontational, educative and delusional-neutral material.
“MCT’s goals are implemented in a group therapy format that works with non-confrontational, educative and delusional-neutral material (21).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [21]
MEBASp operates through a non-confrontational and symptom-neutral "backdoor" approach that could be beneficial to address a transdiagnostic spectrum of patients and diverse needs, foster rapid alliance building, motivate resistant patients, lower drop-out rates, and enhance recovery rather than illness elimination.
“As suggested by Moritz and Woodward (21), MEBASp operates through a non-confrontational and symptom-neutral “backdoor” approach (p. 623) that could be beneficial to address a transdiagnostic spectrum of patients and diverse needs, foster rapid alliance building, motivate resistant patients, lower drop-out rates, and enhance recovery rather than illness elimination (6, 16, 19, 145).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [21]
The therapists' process-oriented stance, which sees psychotic symptoms as extreme manifestations of normal human cognitive distortions and dysfunctional strategies, can foster rapid alliance building.
“The therapists’ process-oriented stance, which sees psychotic symptoms as extreme manifestations of normal human cognitive distortions and dysfunctional strategies, can thereby foster rapid alliance building (21).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [21]
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- Authors
- Moritz, S., & Woodward, T. S.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Simon Fraser University (CA)
- Corresponding author
- Moritz, Steffen
- Venue
- Current Opinion in Psychiatry
- Published
- 2007-11
- Volume
- 20
- Issue
- 6
- Pages
- 619-625
- ISSN
- 0951-7367 (ISSN-L)
- OpenAlex
- W1966491990
- Cited by
- 525
- References
- 53
- Citations by year
- 2026: 19 · 2025: 25 · 2024: 14 · 2023: 23 · 2022: 41 · 2021: 26 · 2020: 58 · 2019: 56 · 2018: 38 · 2017: 28 · 2016: 26 · 2015: 17 · 2014: 26 · 2013: 26 · 2012: 27
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Psychiatry (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
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- metacognitive training, schizophrenia, cognitive biases, paranoid schizophrenia, cognitive behavioral therapy, attribution bias, theory of mind, positive symptoms, knowledge translation, cognitive characteristics
- MeSH terms
- Delusions, Humans, Memory, Schizophrenia, Schizophrenic Psychology, Self Concept, Social Behavior, Cognitive Behavioral Therapy
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