METACOGNITION IN PSYCHOSIS: Implications for developing recovery oriented psychotherapies

In this chapter, the authors use the term 'metacognition' to conceptualize and operationalize the processes involved when persons notice and integrate information about themselves and others. Metacognition is not an academic activity but is the basis for how one decides what to pursue, with whom, where, and when. Patients with more impoverished metacognition are likely to have goals which are general and difficult to connect with actions they may take as an agent. Psychosis in its many different forms leads to myriad psychological and social challenges that affect not only the lives of persons diagnosed with these conditions, but also the lives of their friends, families, and others in their communities. One therapy which explicitly seeks to promote recovery from psychosis by enhancing metacognition is Metacognitive Reflection and Insight Therapy (MERIT). MERIT assumes that recovery from psychosis is to be expected, regardless of how ill, demoralized, or disorganized patients may seem at the start of treatment.