Emotional experience and metacognition among people with schizophrenia: Analysis of session by session and outcome of metacognitive-oriented psychotherapy

Examining the associations between difficulties in emotion regulation and symptomatic outcome measures among individuals with different mental disorders

“…Our findings suggest that exploring ER abilities and their associations with other outcome measures longitudinally could be beneficial for detecting the dynamics of formation and maintenance of clinical symptoms across diagnoses. In addition, in line with recent research indicating the importance of ER abilities in mediating treatment outcomes ( Slee et al, 2008 ; Axelrod et al, 2011 ; Berking et al, 2011 ; Berking and Wupperman, 2012 ; Khakpoor et al, 2019 ; Igra et al, 2022 ), our findings point to the potential role of ER abilities as a specific change mechanism in psychotherapy. Therapeutic interventions that emphasize ER abilities and strategies have already been developed, and our findings call for an in-depth exploration of the role of session-by-session specific ER abilities in psychological treatments for SCZ, EDs, and other conditions.…”

“…Exclusion criteria were intellectual disability, neurological disorders, substance use problems, acute psychosis, and risk for suicidal behavior, based on the intake interview. The first subsample included 36 SCZ who enrolled in a metacognitive reflection insight therapy trial ( Igra et al, 2022 ). The second subsample included 36 other clients who signed up for psychotherapy in the clinic and were diagnosed with major depression, dysthymia, and/or anxiety disorders.…”

Restoring Trust for People With Psychosis Through Psychotherapy

“…Through its emphasis on collaboration and intersubjective reflection, MERIT may provide a roadmap for many challenging interactions in psychotherapy for people experiencing psychosis. Our observations here are broadly supported by the MERIT outcome literature (de Jong et al, 2019; Igra et al, 2022; Lavi-Rotenberg et al, 2020; Vohs et al, 2018). In addition, recent session analysis of MERIT has found evidence that insertion of the therapist's mind, alongside ongoing discussions of perceptions of progress in therapy, was linked with favorable outcomes, including stronger treatment alliance (Lavi-Rotenberg et al, 2020), a concept closely related to the development of trust.…”

“…Helping the patient register their emotions by linking it to bodily sensations might enable the patient to begin to recognize that emotions might influence their perceptions of others (Weijers et al, 2020). Furthermore, greater emotional experience and regulation within psychotherapy sessions has been linked with better outcome, including improved metacognition, in MERIT (Igra et al, 2022). Therapist and patient can also mutually explore what types of emotions might lead to enhanced mistrust in the other's intentions.…”

“…MERIT is an integrative psychotherapy whose effectiveness with individuals diagnosed with serious mental illness is supported through numerous case studies ( e.g. , Arnon-Ribenfeld et al 2018; Hamm et al, 2023; Leonhardt et al 2016) and emerging clinical trials (de Jong et al 2019; Igra et al 2022; Lavi-Rotenberg et al 2020; Vohs et al 2018). MERIT's explicit focus on enhancing metacognition may allow the patient to form not only more awareness of their own thoughts, feelings, and intentions that might lead to suspiciousness but also a more complex understanding of the minds of others, which may decrease interpersonal mistrust.…”