Cited by 102Schizophrenia research and treatmentMental Health and Patient InvolvementMental Health and Psychiatry

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Promoting recovery from severe mental illness: implications from research on metacognition and metacognitive reflection and insight therapy.

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Lysaker, Paul Henry, Hamm, Jay A, Hasson-Ohayon, Ilanit, Pattison, Michelle L, Leonhardt, Bethany L·2018·World Journal of Psychiatry

DOI 10.5498/wjp.v8.i1.1PMC PMC5862649

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Abstract

Research indicates that individuals with schizophrenia recover. Recovery, however means different things to different individuals and regardless of what kind of experiences define recovery, the individual diagnosed with the serious mental illness must feel ownership of their recovery. This raises the issue of how mental health services should systematically promote recovery. This paper explores the practical implications for research on metacognition in schizophrenia for this issue. First, we present the integrated model of metacognition, which defines metacognition as the spectrum of activities which allow individual to have available to themselves an integrated sense of self and others as they appraise and respond to the unique challenges they face. Second, we present research suggesting that many with schizophrenia experience deficits in metacognition and that those deficits compromise individuals' abilities to manage their lives and mental health challenges. Third, we discuss a form of psychotherapy inspired by this research, Metacognitive Reflection and Insight Therapy which assists individuals to recapture the ability to form integrated ideas about themselves and others and so direct their own recovery. The need for recovery oriented interventions to focus on process and on patient's purposes, assess metacognition and consider the intersubjective contexts in which this occurres is discussed.

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“Our intervention’s overarching emphasis on transdiagnostic metacognitive change mechanisms (cognitive insight and cognitive defusion) furthermore fits in a new generation of treatments promoting recovery from serious mental illnesses including psychosis (104, 138).”
Background
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Persons at risk for psychosis overestimate social functioning compared to persons with major depressive disorder and community controls
Mervis, J., Kuhney, F. S., Russell, M. T., Kinney, K. S., Olino, T. M., Mittal, V. A., Schiffman, J. E., & Ellman, L. M. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.02.004 · Cited by 1
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Recovery
Rakitzi, S. (2023) · Springer eBooks · doi:10.1007/978-3-031-27837-2_4
Evolutionary Systems Therapy for Schizotypy: An Integrated Look at Attachment, Compassion and Metacognition
Cheli, S. (2023) · Springer eBooks · doi:10.1007/978-3-031-41788-7_17
Role and limits of socio-normative influences in delusions of control
Pacherie, É. (2025) · Synthese · doi:10.1007/s11229-025-05010-w
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Beyond treatment: making social inclusion central to mental health recovery
Pardo, J. S. D. (2026) · Mental Health and Social Inclusion · doi:10.1108/mhsi-04-2026-0144
Religious Psychopathology: Overview of Clinical, Cultural, and Neurobiological Perspectives
Synadinakis, E., Delis, A., Doska, A., Mourtakos, S., Tzavellas, E., & Doskas, T. K. (2026) · Religions · doi:10.3390/rel17060719
Adherence to elements of metacognition-based therapy for schizophrenia moderates the negative association between therapist-perceived rupture intensity and the client's session evaluation
Hasson‐Ohayon, I., Igra, L., Lavi‐Rotenberg, A., & Atzil–Slonim, D. (2026) · Psychotherapy Research · doi:10.1080/10503307.2026.2691884
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Metacognition and Self-Disturbances in Schizophrenia: Implications for Psychological and Neurocognitive Therapy
Orlov, N. D., Sarzyńska, I., Góral-Półrola, J., Leśnicka, P., Bartkowska, O., Stańczyk, S., Siwiec, E., Ziółkowski, A., & Kopańska, M. (2026) · Brain Sciences · doi:10.3390/brainsci16090956

Authors: Lysaker, P. H., Hamm, J. A., Hasson-Ohayon, I., Pattison, M. L., & Leonhardt, B. L.
Affiliations: Richard L. Roudebush VA Medical Center (US)
Eskenazi Health (US)
University of Indianapolis (US)
Indiana University Indianapolis (US)
ORCID: Lysaker, Paul Henry
Hamm, Jay A
Pattison, Michelle L
Leonhardt, Bethany L
Venue: World Journal of Psychiatry
Publisher: Baishideng Publishing Group Inc.
Published: 2018-03-22
Volume: 8
Issue: 1
Pages: 1-11
ISSN: 2220-3206 (ISSN-L)
DOI: 10.5498/wjp.v8.i1.1
PMC: PMC5862649
OpenAlex: W2794407239
Cited by: 102
References: 76
Citations by year: 2026: 12 · 2025: 9 · 2024: 9 · 2023: 14 · 2022: 3 · 2021: 6 · 2020: 11 · 2019: 21 · 2018: 17
FWCI: 2.12
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: cc-by-nc
Locations: World Journal of Psychiatry (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: schizophrenia, metacognition, Metacognitive Reflection and Insight Therapy, metacognitive deficits, recovery-oriented interventions, self-awareness, intersubjectivity

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Promoting recovery from severe mental illness: implications from research on metacognition and metacognitive reflection and insight therapy.

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