Metacognitive Training to Improve Insight and Work Outcome in Schizophrenia

• Published in: The journal of nervous and mental disease Vol. 210; no. 9; pp. 655 - 658
• Main Authors: Zalzala, Aieyat, Fiszdon, Joanna M., Moritz, Steffen, Wardwell, Patricia, Petrik, Tammy, Mathews, Laura, Shagan, Dana, Bracken, Daniel, Bell, Morris D., Pearlson, Godfrey D., Choi, Jimmy
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-09-2022; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Cognitive Behavioral Therapy; Humans; Metacognition; Psychotic Disorders - therapy; Schizophrenia; Schizophrenia - therapy; Treatment Outcome
• ISSN: 0022-3018; 1539-736X; 1539-736X
• DOI: 10.1097/NMD.0000000000001512

Individuals with psychotic disorders have deficits in metacognition. Thirty-four adults with schizophrenia were randomized to 2 months of metacognitive training (MCT) or a healthy living skills control group. All participants were enrolled in a work therapy program, followed by a supported employment program. Assessments were conducted at baseline, at the end of the 2-month active intervention, and at 4- and 12-month follow-ups. At the end of active intervention, the MCT group demonstrated greater improvement and better work behavior relative to controls. At follow-up, the MCT group demonstrated significantly greater insight and fewer positive symptoms and a greater percentage were employed in the community. We speculate that being better able to think about one's thoughts, recognize biases in thinking, and correct those thoughts may aid in responding to workplace challenges and hence improve work outcomes.