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  • A practice-oriented review on effectiveness of metacognitive training (MCT) for psychosis
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  • A practice-oriented review on effectiveness of metacognitive training (MCT) for psychosis

A practice-oriented review on effectiveness of metacognitive training (MCT) for psychosis

Imke L.J. Lemmers-Janse, Steffen Moritz

Accepted April 30, 2021

First published April 30, 2021

https://doi.org/10.26387/bpa.290.3

Abstract

This review contains a practical overview of the metacognitive training for psychosis (MCT); practical issues concerning the use and administration of the training are presented. MCT consists of two cycles of 8 modules (plus two additional modules). Reviews and meta-analyses have demonstrated the feasibility and high acceptance by patients. Medium effect sizes are reported with regard to reduction of psychotic symptoms. Effects on jumping to conclusions are mixed. Largest effects are reported when patients have more general, and mild to moderate psychotic symptoms, and when the two full cycles are completed. Strengths and limitations are discussed, and recommendations for use and future research are presented. MCT is a meaningful addition to the treatment of psychosis.

References

  • AGHOTOR, J., PFUELLER, U., MORITZ, S., WEISBROD, M. &ROESCH-ELY, D. (2010). Metacognitive training for patientswith schizophrenia (MCT): Feasibility and preliminary evidencefor its efficacy. Journal of Behavior Therapy and ExperimentalPsychiatry, 41 (3), 207-211.

    doi.org/10.1016/j.jbtep.2010.01.004

  • AHUIR, M., CABEZAS, Á., MIÑANO, M.J., ALGORA, M.J.,ESTRADA, F., SOLÉ, M., GUTIÉRREZ-ZOTES, A., TOST,M., BARBERO, J.D., MONTALVO, I., SÁNCHEZ-GISTAU, V.,MONREAL, J.A., VILELLA, E., PALAO, D. & LABAD, J. (2018).Improvement in cognitive biases after group psychoeducationand metacognitive training in recent-onset psychosis: Arandomized crossover clinical trial. Psychiatry Research, 270,720-723.

    doi.org/10.1016/j.psychres.2018.10.066

  • AMERICAN PSYCHIATRIC ASSOCIATION (2013). Diagnosticand statistical manual of mental disorders (DSM-5®). AmericanPsychiatric Pub.

  • ANDREOU, C., STEINMANN, S., LEICHT, G., KOLBECK, K.,MORITZ, S. & MULERT, C. (2018). fMRI correlates of jumping-to-conclusions in patients with delusions: Connectivity patternsand effects of metacognitive training. NeuroImage Clinical, 20,119-127.

    doi.org/10.1016/j.nicl.2018.07.004

  • BENTALL, R.P. (1994). Cognitive biases and abnormal beliefs:Towards a model of persecutory delusions. In A.S. David & J.C.Cutting (Eds.), The neuropsychology of schizophrenia. LawrenceErlbaum Associates, Inc.

  • BRIKI, M., MONNIN, J., HAFFEN, E., SECHTER, D., FAVROD,J., NETILLARD, C., CHERAITIA, E., MARIN, K.,GOVYADOVSKAYA, S., TIO, G., BONIN, B., CHAUVET-GELINIER, J.C., LECLERC, S., HODÉ, Y., VIDAILHET,P., BERNA, F., BERTSCHY, A.Z. & VANDEL, P. (2014).Metacognitive training for schizophrenia: A multicentrerandomised controlled trial. Schizophrenia Research, 157 (1-3),99-106.

    doi.org/10.1016/j.schres.2014.06.005

  • BROYD, A., BALZAN, R.P., WOODWARD, T.S. & ALLEN, P. (2017).Dopamine, cognitive biases and assessment of certainty: Aneurocognitive model of delusions. Clinical Psychology Review,54, 96-106.

    doi.org/10.1016/j.cpr.2017.04.006

  • BRÜNE,M.,DIMAGGIO,G.&LYSAKER,P.H.(2011).Metacognitionand social functioning in schizophrenia: Evidence, mechanismsof influence and treatment implications. Current PsychiatryReviews, 7 (3), 239-247.

    doi.org/10.2174/157340011797183210

  • CASPI,A.,DAVIDSON,M.&TAMMINGA,C.A.(2004).Treatment-refractory schizophrenia. Dialogues in Clinical Neuroscience, 6(1), 61-70.

    doi.org/10.31887/DCNS.2004.6.1/acaspi

  • DUDLEY, R., TAYLOR, P., WICKHAM, S. & HUTTON, P. (2016).Psychosis, delusions and the “jumping to conclusions” reasoningbias: A systematic review and meta-analysis. SchizophreniaBulletin, 42 (3), 652-665.

    doi.org/10.1093/schbul/sbv150

  • EICHNER, C. & BERNA, F. (2016). Acceptance and efficacy ofMetacognitive Training (MCT) on positive symptoms anddelusions in patients with schizophrenia: A meta-analysis takinginto account important moderators. Schizophrenia Bulletin, 42(4), 952-962.

    doi.org/10.1093/schbul/sbv225

  • FAVROD, J., REXHAJ, S., BARDY, S., FERRARI, P., HAYOZ, C.,MORITZ, S., CONUS, P. & BONSACK, C. (2014). Sustainedantipsychotic effect of metacognitive training in psychosis: Arandomized-controlled study. European Psychiatry: The Journalof the Association of European Psychiatrists, 29 (5), 275-281.

    doi.org/10.1016/j.eurpsy.2013.08.003

  • GAWEDA, Ł., KREZOŁEK, M., OLBRYŚ, J., TURSKA, A. &KOKOSZKA, A. (2015). Decreasing self-reported cognitivebiases and increasing clinical insight through meta-cognitivetraining in patients with chronic schizophrenia. Journal ofBehavior Therapy and Experimental Psychiatry, 48, 98-104.

    doi.org/10.1016/j.jbtep.2015.02.002

  • HOWE, L.J. & BROWN, I.D. (2015). Investigating the usefulness ofa metacognitive training group programme for schizophrenia.BJPsych Bulletin, 39 (3), 114-118.

    doi.org/10.1192/pb.bp.113.046037

  • HUHN, M., NIKOLAKOPOULOU, A., SCHNEIDER-THOMA,J., KRAUSE, M., SAMARA, M., PETER, N., ARNDT, T.,BÄCKERS, L., ROTHE, P., CIPRIANI, A., DAVIS, J., SALANTI,G. & LEUCHT, S. (2020). Comparative efficacy and tolerabilityof 32 oral antipsychotics for the acute treatment of adults withmulti-episode schizophrenia: A systematic review and networkmeta-analysis. Focus (American Psychiatric Publishing), 18 (4),443-455.

    doi.org/10.1176/appi.focus.18306

  • ISHIKAWA, R., ISHIGAKI, T., SHIMADA, T., TANOUE, H.,YOSHINAGA, N., ORIBE, N., MORIMOTO, T., MATSUMOTO,T. & HOSONO, M. (2020). The efficacy of extendedmetacognitive training for psychosis: A randomized controlledtrial. Schizophrenia Research, 215, 399-407.

    doi.org/10.1016/j.schres.2019.08.006

  • JELINEK, L., FAISSNER, M., MORITZ, S. & KRISTON, L. (2019).Long-term efficacy of Metacognitive Training for Depression(D-MCT): A randomized controlled trial. The British Journal ofClinical Psychology, 58 (3), 245-259.

    doi.org/10.1111/bjc.12213

  • JIANG, J., ZHANG, L., ZHU, Z., LI, W. & LI, C. (2015). Metacognitivetraining for schizophrenia: A systematic review. ShanghaiArchives of Psychiatry, 27 (3), 149-157.

    doi.org/10.11919/j.issn.1002-0829.215065

  • KÖTHER, U., VETTORAZZI, E., VECKENSTEDT, R.,HOTTENROTT, B., BOHN, F., SCHEU, F., PFUELLER, U.,ROESCH-ELY, D. & MORITZ, S. (2017). Bayesian analysesof the effect of metacognitive training on social cognitiondeficits and overconfidence in errors. Journal of ExperimentalPsychopathology, 158-174.

    doi.org/10.5127/jep.054516

  • KUMAR, D., MENON, M., MORITZ, S. & WOODWARD, T.S.(2015).Usingthebackdoor:Metacognitivetrainingforpsychosis.Psychosis: Psychological, Social and Integrative Approaches, 7 (2),166-178.

    doi.org/10.1080/17522439.2014.913073

  • KUMAR, D., UL HAQ, M. Z., DUBEY, I., DOTIVALA, K.N.,SIDDIQUI, S.V., PRAKASH, R., ABHISHEK, P. & NIZAMIE,S.H. (2010). Effect of meta-cognitive training in the reductionof positive symptoms in schizophrenia. European Journal ofPsychotherapy and Counselling, 12 (2), 149-158.

    doi.org/10.1080/13642537.2010.488875

  • KUOKKANEN, R., LAPPALAINEN, R., REPO-TIIHONEN, E. &TIIHONEN, J. (2014). Metacognitive group training for forensicand dangerous non-forensic patients with schizophrenia: Arandomised controlled feasibility trial. Criminal Behaviourand Mental Health: CBMH, 24 (5), 345-357.

    doi.org/10.1002/cbm.1905

  • LAM, K.C., HO, C.P., WA, J.C., CHAN, S.M., YAM, K.K., YEUNG,O.S., WONG, W.C. & BALZAN, R.P. (2015). Metacognitivetraining (MCT) for schizophrenia improves cognitive insight:a randomized controlled trial in a Chinese sample withschizophrenia spectrum disorders. Behaviour Research andTherapy, 64, 38-42.

    doi.org/10.1016/j.brat.2014.11.008

  • LEANZA, L., STUDERUS, E., BOZIKAS, V.P., MORITZ, S. &ANDREOU, C. (2020). Moderators of treatment efficacy inindividualized metacognitive training for psychosis (MCT+). .Journal of Behavior Therapy and Experimental Psychiatry, 68,101547.

    doi.org/10.1016/j.jbtep.2020.101547

  • LIU, Y.C., TANG, C.C., HUNG, T.T., TSAI, P.C. & LIN, M.F. (2018).The efficacy of metacognitive training for delusions in patientswith schizophrenia: A meta-analysis of randomized controlledtrials informs evidence-based practice. Worldviews on Evidence-based Nursing, 15 (2), 130-139.

    doi.org/10.1111/wvn.12282

  • LOPEZ-MORINIGO, J.D., AJNAKINA, O., MARTÍNEZ, A.S.,ESCOBEDO-AEDO, P.J., RUIZ-RUANO, V.G., SÁNCHEZ-ALONSO, S., MATA-ITURRALDE, L., MUÑOZ-LORENZO,L., OCHOA, S., BACA-GARCÍA, E. & DAVID, A.S. (2020). Canmetacognitive interventions improve insight in schizophreniaspectrum disorders? A systematic review and meta-analysis.Psychological medicine, 50 (14), 2289-2301.

    doi.org/10.1017/S0033291720003384

  • LÜDTKE, T., PULT, L.K., SCHRÖDER, J., MORITZ, S. & BÜCKER,L. (2018). A randomized controlled trial on a smartphone self-help application (be good to yourself) to reduce depressivesymptoms. Psychiatry Research, 269, 753-762.

    doi.org/10.1016/j.psychres.2018.08.113

  • MENON, M., BALZAN, R.P., HARPER, K., KUMAR, D.,ANDERSEN, D., MORITZ, S. & WOODWARD, T.S. (2017).Psychosocial approaches in the treatment of psychosis: CognitiveBehavior Therapy for psychosis (CBTp) and MetacognitiveTraining (MCT). Clinical Schizophrenia & Related Psychoses, 11(3), 156-163.

    doi.org/10.3371/CSRP.MEBA.022015

  • MIEGEL, F., CLUDIUS, B., HOTTENROTT, B., DEMIRALAY, C.,SURE, A. & JELINEK, L. (2020). Session-specific effects of theMetacognitive Training for Obsessive-Compulsive Disorder(MCT-OCD). Psychotherapy Research: Journal of the Society forPsychotherapy Research, 30 (4), 474-486.

    doi.org/10.1080/10503307.2019.1613582

  • MORITZ, S., ANDREOU, C., SCHNEIDER, B.C., WITTEKIND,C.E., MENON, M., BALZAN, R.P. & WOODWARD, T.S. (2014).Sowing the seeds of doubt: A narrative review on metacognitivetraining in schizophrenia. Clinical Psychology Review, 34 (4),358-366.

    doi.org/10.1016/j.cpr.2014.04.004

  • MORITZ, S., KERSTAN, A., VECKENSTEDT, R., RANDJBAR, S.,VITZTHUM, F., SCHMIDT, C., HEISE, M. & WOODWARD,T.S. (2011). Further evidence for the efficacy of a metacognitivegrouptraininginschizophrenia.BehaviourResearchandTherapy,49 (3), 151-157.

    doi.org/10.1016/j.brat.2010.11.010

  • MORITZ, S., MENON, M., ANDERSEN, D., WOODWARD, T.S. &GALLINAT, J. (2018). Moderators of symptomatic outcome inmetacognitive training for psychosis (MCT). Who benefits andwho does not? Cognitive Therapy and Research, 42 (1), 80-91.

    doi.org/10.1007/s10608-017-9868-3

  • MORITZ, S. & SCHNEIDER, B. (2016). From the incomprehensibleto the partially understood. An update on cognitive bias researchand metacognitive training in schizophrenia psychosis. CurrentTreatment Options in Psychiatry, 3, 83-98.

    doi.org/10.1007/s40501-016-0081-x

  • MORITZ, S., VECKENSTEDT, R., ANDREOU, C., BOHN,F., HOTTENROTT, B., LEIGHTON, L., KÖTHER, U.,WOODWARD, T.S., TRESZL, A., MENON, M., SCHNEIDER,B.C., PFUELLER, U. & ROESCH-ELY, D. (2014). Sustainedand “sleeper” effects of group metacognitive training forschizophrenia: A randomized clinical trial. JAMA Psychiatry, 71(10), 1103-1111.

    doi.org/10.1001/jamapsychiatry.2014.1038

  • MORITZ, S., VECKENSTEDT, R., BOHN, F., HOTTENROTT,B., SCHEU, F., RANDJBAR, S., AGHOTOR, J., KÖTHER, U.,WOODWARD, T.S., TRESZL, A., ANDREOU, C., PFUELLER,U. & ROESCH-ELY, D. (2013). Complementary groupmetacognitive training (MCT) reduces delusional ideation inschizophrenia. Schizophrenia Research, 151 (1-3), 61-69.

    doi.org/10.1016/j.schres.2013.10.007

  • MORITZ, S., VECKENSTEDT, R., RANDJBAR, S., VITZTHUM, F.& WOODWARD, T.S. (2011). Antipsychotic treatment beyondantipsychotics: Metacognitive intervention for schizophreniapatients improves delusional symptoms. Psychological Medicine,41 (9), 1823-1832.

    doi.org/10.1017/S0033291710002618

  • MORITZ, S., VITZTHUM, F., RANDJBAR, S., VECKENSTEDT,R. & WOODWARD, T.S. (2010). Detecting and defusingcognitive traps: Metacognitive intervention in schizophrenia.Current Opinion in Psychiatry, 23 (6), 561-569.

    doi.org/10.1097/YCO.0b013e32833d16a8

  • MORITZ, S. & WOODWARD, T.S. (2006). Metacognitive controlover false memories: A key determinant of delusional thinking.Current Psychiatry Reports, 8 (3), 184-190. doi.org/10.1007/s11920-006-0022-2MORITZ, S. & WOODWARD, T.S. (2007a). Metacognitive trainingfor schizophrenia patients (MCT): A pilot study on feasibility,treatment adherence, and subjective efficacy. German Journal ofPsychiatry, 10 (3), 69-78.MORITZ, S. & WOODWARD, T.S. (2007b). Metacognitive trainingin schizophrenia: From basic research to knowledge translationand intervention. Current Opinion in Psychiatry, 20 (6), 619-625.

    doi.org/10.1097/YCO.0b013e3282f0b8ed

  • MORITZ, S., WOODWARD, T.S. & BALZAN, R. (2016). Ismetacognitive training for psychosis effective? Expert Review ofNeurotherapeutics, 16 (2), 105-107.

    doi.org/10.1586/14737175.2016.1135737

  • NAUGHTON, M., NULTY, A., ABIDIN, Z., DAVOREN, M.,O’DWYER, S. & KENNEDY, H.G. (2012). Effects of groupmetacognitive training (MCT) on mental capacity and functioningin patients with psychosis in a secure forensic psychiatric hospital:A prospective-cohort waiting list controlled study. BMC ResearchNotes, 5, 302.

    doi.org/10.1186/1756-0500-5-302

  • OCHOA, S., LÓPEZ-CARRILERO, R., BARRIGÓN, M.L., POUSA,E., BARAJAS, A., LORENTE-ROVIRA, E., GONZÁLEZ-HIGUERAS, F., GRASA, E., RUIZ-DELGADO, I., CID, J.,BIRULÉS, I., ESTEBAN-PINOS, I., CASAÑAS, R., LUENGO, A.,TORRES-HERNÁNDEZ, P., CORRIPIO, I., MONTES-GÁMEZ,M., BELTRAN, M., DE APRAIZ, A., DOMÍNGUEZ-SÁNCHEZ,L., … & SPANISH METACOGNITION STUDY GROUP (2017).Randomized control trial to assess the efficacy of metacognitivetraining compared with a psycho-educational group in peoplewith a recent-onset psychosis. Psychological Medicine, 47 (9),1573-1584.

    doi.org/10.1017/S0033291716003421

  • PANKOWSKI, D., KOWALSKI, J. & GAWEDA, Ł. (2016). Theeffectiveness of metacognitive training for patients withschizophrenia: A narrative systematic review of studies publishedbetween 2009 and 2015. Skutecznośc treningu metapoznawczegou osób chorujacych na schizofrenie: Narracyjny przegladsystematyczny badan opublikowanych w latach 2009–2015.Psychiatria Polska, 50 (4), 787-803.

    doi.org/10.12740/PP/59113

  • PHILIPP, R., KRISTON, L., LANIO, J., KÜHNE, F., HÄRTER,M., MORITZ, S. & MEISTER, R. (2019). Effectiveness ofmetacognitive interventions for mental disorders in adults: Asystematic review and meta-analysis (METACOG). ClinicalPsychology & Psychotherapy, 26 (2), 227-240.

    doi.org/10.1002/cpp.2345

  • PIJNENBORG, G.H., VAN DONKERSGOED, R.J., DAVID, A.S. &ALEMAN, A. (2013). Changes in insight during treatment forpsychotic disorders: A meta-analysis. Schizophrenia Research,144 (1-3), 109-117.

    doi.org/10.1016/j.schres.2012.11.018

  • POS,K.,MEIJER,C.J.,VERKERK,O.,ACKEMA,O.,KRABBENDAM,L. & DE HAAN, L. (2018). Metacognitive training in patientsrecovering from a first psychosis: An experience sampling studytesting treatment effects. European Archives of Psychiatry andClinical Neuroscience, 268 (1), 57-64.

    doi.org/10.1007/s00406-017-0833-7

  • ROSS, K., FREEMAN, D., DUNN, G. & GARETY, P. (2011). Arandomized experimental investigation of reasoning training forpeople with delusions. Schizophrenia Bulletin, 37 (2), 324-333.

    doi.org/10.1093/schbul/sbn165

  • SAUVÉ, G., LAVIGNE, K.M., POCHIET, G., BRODEUR, M.B. &LEPAGE, M. (2020). Efficacy of psychological interventionstargeting cognitive biases in schizophrenia: A systematic reviewand meta-analysis. Clinical Psychology Review, 78, 101854.

    doi.org/10.1016/j.cpr.2020.101854

  • SCHILLING, L., MORITZ, S., KRISTON, L., KRIEGER, M. &NAGEL, M. (2018). Efficacy of metacognitive training forpatientswithborderlinepersonalitydisorder:Preliminaryresults.Psychiatry Research, 262, 459-464. https:/

    doi.org/10.1016/j.psychres.2017.09.024

  • SCHNEIDER, B.C., BÜCKER, L., RIKER, S., KARAMATSKOS, E.& JELINEK, L. (2018). A pilot study of metacognitive training(D-MCT) for older adults with depression. Zeitschrift fürNeuropsychologie, 29 (1), 7-19.

    doi.org/10.1024/1016-264X/a000210

  • TURNER, D.T., MacBETH, A., LARKIN, A., MORITZ, S.,LIVINGSTONE, K., CAMPBELL, A. & HUTTON, P. (2019). TheEffect of reducing the “jumping to conclusions” bias on treatmentdecision-making capacity in psychosis: A randomized controlledtrial with mediation analysis. Schizophrenia Bulletin, 45 (4), 784-793.

    doi.org/10.1093/schbul/sby136

  • USSORIO, D., GIUSTI, L., WITTEKIND, C.E., BIANCHINI,V., MALAVOLTA, M., POLLICE, R., CASACCHIA, M. &RONCONE, R. (2016). Metacognitive training for youngsubjects (MCT young version) in the early stages of psychosis: Isthe duration of untreated psychosis a limiting factor? Psychologyand Psychotherapy, 89 (1), 50-65.

    doi.org/10.1111/papt.12059

  • VAN OOSTERHOUT, B., KRABBENDAM, L., DE BOER, K.,FERWERDA, J., VAN DER HELM, M., STANT, A.D. & VANDER GAAG, M. (2014). Metacognitive group training forschizophrenia spectrum patients with delusions: A randomizedcontrolled trial. Psychological Medicine, 44 (14), 3025-3035. doi.org/10.1017/S0033291714000555VAN OOSTERHOUT, B., SMIT, F., KRABBENDAM, L.,CASTELEIN, S., STARING, A.B. & VAN DER GAAG, M.(2016a). Metacognitive training for schizophrenia spectrumpatients: A meta-analysis on outcome studies. PsychologicalMedicine, 46 (1), 47-57. doi.org/10.1017/S0033291715001105VAN OOSTERHOUT, B., SMIT, F., KRABBENDAM, L.,CASTELEIN, S., STARING, A.B.P. & VAN DER GAAG, M.(2016b). Letter to the editor: Should we focus on quality orquantity in meta-analyses? Psychological Medicine, 46 (9), 2003-2005.

    doi.org/10.1017/S003329171600009X

  • WOODWARD, T.S., MORITZ, S., CUTTLER, C. & WHITMAN,J.C. (2006). The contribution of a cognitive bias againstdisconfirmatory evidence (BADE) to delusions in schizophrenia.Journal of Clinical and Experimental Neuropsychology, 28 (4),605-617.

    doi.org/10.1080/13803390590949511
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Issue:

Issue 290

Keywords:

Delusions

Improved wellbeing

Metacognitive training

Practical issues

Reasoning biases

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Lemmers-Janse Imke L.J.. Moritz Steffen. A practice-oriented review on effectiveness of metacognitive training (MCT) for psychosis. BPA Applied Psychology Bulletin. 2021;290(1):24-34. doi:10.26387/bpa.290.1.
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Author Surname Author Initial. Title. Publication Title. Year Published;Volume number(Issue number):Pages Used. doi:DOI Number.


Lemmers-Janse Imke L.J.. Moritz Steffen. A practice-oriented review on effectiveness of metacognitive training (MCT) for psychosis. BPA Applied Psychology Bulletin. 2021;290(1):24-34. doi:10.26387/bpa.290.1.