Metacognitive training

What is metacognitive training?

Research has found that many people with schizophrenia have biased cognitive processes, and have a lack of insight about these problems. Biased cognitive processes are thought to underlie delusional beliefs. The aim of metacognitive training is to make patients aware of delusion-relevant cognitive biases and then to amend these biases. Cognitive biases in people with schizophrenia involve a tendency to jump to conclusions based on a small amount of information, and make errors when trying to find reasons for their own and others’ behaviours. Research has shown that people with schizophrenia are often unsure about their correct interpretation of information, but are over-confident about their incorrect interpretation of information. Metacognitive training involves eight group sessions with three to ten patients, and is based on three fundamental components. First, knowledge translation involves describing cognitive biases in a way that explains how they contribute to the formation of delusions. Second is the use of specific exercises to raise awareness about the negative consequences of cognitive biases, and third, patients are taught alternative thinking strategies to help them avoid the cognitive biases that can lead to delusional beliefs. Patients are encouraged to express personal examples of biases, and discuss ways to counter them, serving to provide corrective experiences in a supportive atmosphere.

What is the evidence for metacognitive training?

Moderate to high quality evidence finds metacognitive training can improve overall positive symptoms and delusions in people with schizophrenia. Moderate to low quality evidence finds the improvement in delusions can persist for up to 6 months post-treatment.

May 2019

Last updated at: 4:44 am, 30th May 2019
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