Metacognitive training, (MCT), is an approach for treating the symptoms of

psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...

, especially

delusion A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or som ...

s, which has been adapted for other disorders such as depression, obsessive-compulsive disorder and borderline over the years (see below and external links for free download). It was developed by Steffen Moritz and Todd Woodward. The intervention is based on the theoretical principles of cognitive behavioral therapy, but focuses in particular on problematic thinking styles (

cognitive biases A cognitive bias is a systematic pattern of deviation from norm or rationality in judgment. Individuals create their own "subjective reality" from their perception of the input. An individual's construction of reality, not the objective input, m ...

) that are associated with the development and maintenance of positive symptoms; e.g. overconfidence in errors and

jumping to conclusions Jumping to conclusions (officially the jumping conclusion bias, often abbreviated as JTC, and also referred to as the inference-observation confusion) is a psychological term referring to a communication obstacle where one "judge or decide somethin ...

. Metacognitive training exists as a group training (MCT) and as an individualized intervention (MCT+).

Background

Metacognition can be defined as "thinking about thinking". Over the course of the training, cognitive biases subserving positive symptoms are identified and corrected. The current empirical evidence assumes a connection between certain cognitive biases, such as jumping to conclusions, and the development and maintenance of psychosis. Accordingly, correcting these problematic/unhelpful thinking styles should lead to a reduction of symptoms.

Intervention

In eight training units (modules) and two additional modules, examples of "cognitive traps", which can promote the development and maintenance of the positive symptoms of schizophrenia, are presented to patients in a playful way. Patients are instructed to critically reflect on their thought patterns, which may contribute to problematic behaviors, and to implement the contents of the training in everyday life. MCT deals with the following problematic styles of thinking: monocausal attributions, jumping to conclusions, inflexibility, problems in social cognition, overconfidence for memory errors and depressive thought patterns. The additional modules deal with stigma and low self-esteem. Individualized metacognitive training (MCT+) targets the same symptoms and cognitive biases as the group training, but is more flexible in that it allows discussion of individualized topics. The treatment materials for the group training can be obtained free of charge in over 30 languages from the website.

Efficacy

A recent

meta-analysis A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...

found significant improvements for positive symptoms and delusions, as well as the acceptance of the training. These findings have been replicated in 2018 and 2019. An older meta-analysis based on a smaller number of studies found a small effect, which reached significance when newer studies were considered. Individual studies provide evidence for the long-term effectiveness of the approach beyond the immediate treatment period. MCT is recommended as an evidence-based treatment by the

Royal Australian and New Zealand College of Psychiatrists The Royal Australian and New Zealand College of Psychiatrists (RANZCP) is the principal organisation representing the medical specialty of psychiatry in Australia and New Zealand and has responsibility for training, examining and awarding the qual ...

as well as the German Association for Psychiatry, Psychotherapy and Psychosomatics.

Adaptations to other disorders

Since its introduction, MCT has been adapted to other mental disorders. Empirical studies have been carried out for borderline personality disorder, obsessive-compulsive disorder (self-help approach), depression, bipolar disorders, and problem gambling.

References

External links

Metacognitive Training for Psychosis
Link to training material and manual (free).
Metacognitive Training for Psychosis, Individualized (MCT+)
Link to training material and manual (free).
Metacognitive Training for Obsessive-Compulsive Disorder (myMCT)
Link to training material and self-help manual (free).
Metacognitive Training for Depression
Link to training material and manual (free).
Metacognitive Training for Borderline Personality Disorder
Link to training material and manual (free). {{Psychotherapy Psychotherapies Cognitive behavioral therapy Schizophrenia