Metacognitive intervention in early psychosis : a pilot study

Abstract

Background: Metacognitive training (MCT) is a specialized therapy program for people with psychotic disorders. It emphasizes on raising patient awareness of the key symptoms of psychotic disorders, such as delusions, hallucinations, cognitive biases and other cognitive impairments that can promote and maintain symptoms of psychosis. MCT is both available as a group training and as individual therapy, and in this present trial both programs were combined. Method: A total of 16 patients in an early intervention in psychosis (EIP) service were randomly assigned to either intervention group (n = 8), that received both MCT group training and individual therapy for 10 weeks, or a wait-list control group (n = 8). Both groups were assessed before and after the intervention on the severity of positive symptoms, social cognition, cognitive insights, self-esteem and social functioning. Acceptance and feasibility were assessed after the intervention for participants, treatment facilitators and managers at the EIP service.Results: Acceptance and feasibility measures gave good results. Large effect sizes were found on three measures in favor of the MCT intervention, indicating improvement in insight and social cognition and a lower aggression bias. Conclusions: The results suggest that combined group MCT and individual therapy is a favorable treatment in early psychosis with high acceptance and feasibility. These results are promising for the ongoing study at the EIP service and with a larger sample we hope to be able to understand the effects of the treatment better. Key words: Metacognitive training, psychotic disorders, positive symptoms, cognitive biases, cognitive insight, social cognition.