Metacognitive Reflection and Insight Therapy (MERIT) With a Patient With Severe Symptoms of Disorganization

Jong, Steven de; Donkersgoed, Rozanne van; Pijnenborg, Gerdina H. M.; Lysaker, Paul H.

doi:10.1002/jclp.22249

Cited by 36 publications

(28 citation statements)

References 13 publications

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“…The intervention has been shown to increase self-esteem and quality of life while decreasing selfstigma (Roe et al, 2014). Metacognitive orientated psychotherapy has also been shown to enhance personal narratives (de Jong, van Donkersgoed, Pijnenborg, & Lysaker, 2016;Leonhardt, 2016 andHillis et al, 2015) and taken together these approaches demonstrate the Notice: This is the author's version of a work that was accepted for publication in Consciousness and Cognition. A definitive version was subsequently published in Consciousness andCognition, 45, 60-74.…”

Section: Neurocognition Negative Symptoms and Life Storiesmentioning

confidence: 99%

Life story chapters and narrative self-continuity in patients with schizophrenia

Holm

Thomsen

Bliksted

2016

Consciousness and Cognition

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The present study compared life story chapters and self-defining memories in 25 patients with schizophrenia and 25 matched controls. All participants were tested on neurocognition and rated on symptoms. Participants identified and rated life story chapters and self-defining memories on emotional valence, causal coherence, and self-continuity. Temporal coherence and temporal macrostructure were also assessed. Patients rated their life story chapters as more negative compared to controls, but there were few significant differences regarding temporal coherence, temporal macrostructure, and ratings of causal coherence and self-continuity. In patients, poorer neurocognitive function and higher degree of negative symptoms were related to less causal coherence and lower self-continuity in relation to chapters. In general, few differences were found between the patients and the controls. This may be due to the highly structured method used to assess life stories or to the fact that our patient group was cognitively well-functioning.

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Section: Neurocognition Negative Symptoms and Life Storiesmentioning

confidence: 99%

Life story chapters and narrative self-continuity in patients with schizophrenia

Holm

Thomsen

Bliksted

2016

Consciousness and Cognition

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“…Accumulating evidence exists regarding the effectiveness of MERIT and similar therapies. Case studies showed increased metacognitive abilities and improvement in functioning (Arnon‐Ribenfeld et al ., ; Bargenquast, Schweitzer, & Drake, ; Buck & George, ; Buck & Lysaker, ; Hasson‐Ohayon, Arnon‐Ribenfeld, Hamm, & Lysaker, ; Hillis et al ., ; Lysaker et al ., ; Schweitzer, Greben, & Bargenquast, ), even in patients with severe disorganization (de Jong, van Donkersgoed, Pijnenborg, & Lysaker, ; Hamm & Firmin, ), negative symptoms (van Donkersgoed, de Jong, & Pijnenborg, ), and impaired insight (Leonhardt et al ., ). One open trial and a pilot study have reported positive outcomes (Bargenquast & Schweitzer, ; de Jong, van Donkersgoed, Aleman, et al ., ), in particular on Self‐Reflectivity.…”

Section: Introductionmentioning

confidence: 99%

A qualitative evaluation of the effects of Metacognitive Reflection and Insight Therapy: ‘Living more consciously’

Jong

Hasson‐Ohayon

Donkersgoed³

et al. 2018

Psychol Psychother

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Objectives Extensive research showed that one of the major difficulties that people with schizophrenia spectrum disorders are struggling with involves their ability to reflect on their own and others’ mental activities, also defined as metacognition. Several new psychotherapies have been developed to assist patients (re)gain metacognitive capacity, including Metacognitive Reflection and Insight Therapy (MERIT). The current study investigated the client's subjective experience of psychotherapy, to determine whether service users found MERIT effective and whether these gains align with quantitative findings, which processes they considered responsible for these benefits, in which ways participants found MERIT similar or different from other interventions, and whether they experienced non‐desirable factors and outcomes. Design All participants who had participated in a randomized controlled trial investigating the efficacy of MERIT were offered a structured post‐therapy interview by an independent assessor. Fourteen out of 18 (77%) participants, all of whom had completed therapy, responded. Results Most participants (10/14) indicated that they had experienced the therapy as beneficial to their recovery, and in general contributed to their understanding of their own thinking, which maps closely onto the quantitative findings reported elsewhere. They mainly attributed these changes to their own active role in therapy, the intervention letting them vent and self‐express, and forming an alliance with the therapist. Conclusions Participants reports of change map closely onto the quantitative findings from the randomized controlled trial. Findings are discussed in the frameworks of the metacognitive model of psychosis and the integrative intersubjective model of psychotherapy for psychosis emphasizing the role of the clients as active agent of change. Practitioner points The use of a systematic, qualitative interview at the conclusion of therapy may yield important information regarding process and outcome. Analysis of the interview revealed that clients’ perceptions regarding change within themselves closely maps onto quantitative findings. MERIT may not be the appropriate intervention for all clients; some may prefer a more solution‐oriented approach such as CBTp or Metacognition‐Oriented Social Skills training. Self‐expressing with a trained clinician may be therapeutic in itself.

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“…MERIT is built on eight core principles that the therapist has to adhere to in every session. Multiple case reports have documented the acceptability of this treatment and positive outcomes (Buck and Lysaker 2009 ; Lysaker et al 2007 ; Salvatore et al 2009 , 2012 ; Hillis et al 2015 ; Kukla et al 2015 ; De Jong et al 2016 ) and a randomized controlled trial is currently conducted in the Netherlands to assess the effectiveness of the therapy (Van Donkersgoed et al 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Metacognitive Reflection and Insight Therapy (MERIT) with a Patient with Persistent Negative Symptoms

Donkersgoed

Jong

Pijnenborg

2016

J Contemp Psychother

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Metacognition comprises a spectrum of mental activities involving thinking about thinking. Metacognitive impairments may sustain and trigger negative symptoms in people with schizophrenia. Without complex ideas of the self and others, there may be less reason to pursue goal-directed activities and less ability to construct meaning in daily activities, leading to the experience of negative symptoms. As these symptoms tend to be nonresponsive to pharmacotherapy and other kinds of treatment metacognition might be a novel treatment target; improvement of metacognition might lead to improvements in negative symptoms. One therapy that seeks to promote metacognition is the Metacognitive Reflection and Insight Therapy (MERIT). In this study, a case is presented in which a first episode patient with severe negative symptoms is treated with MERIT. A case illustration and the eight core principles of MERIT are presented. Independent assessments of metacognition and negative symptoms before and after therapy show a significant increase of metacognition and decrease of negative symptoms over the course of 40 weeks.

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Metacognitive Reflection and Insight Therapy (MERIT) With a Patient With Severe Symptoms of Disorganization

Cited by 36 publications

References 13 publications

Life story chapters and narrative self-continuity in patients with schizophrenia

Life story chapters and narrative self-continuity in patients with schizophrenia

A qualitative evaluation of the effects of Metacognitive Reflection and Insight Therapy: ‘Living more consciously’

Metacognitive Reflection and Insight Therapy (MERIT) with a Patient with Persistent Negative Symptoms

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