Metacognitive training for psychosis (MCT): past, present, and future

TY - JOUR

T1 - Metacognitive training for psychosis (MCT): past, present, and future

AU - Moritz, Steffen

AU - Menon, Mahesh

AU - Balzan, Ryan

AU - Woodward, Todd S

N1 - © 2022. The Author(s).

PY - 2023/6

Y1 - 2023/6

N2 - This article provides an overview and retrospective on metacognitive training for psychosis (MCT), which first appeared approximately 2 decades ago. We recount how our empirical understanding of psychosis at that time led to the first preliminary version of the program. We describe setbacks and challenges that led to major changes, including revisions to existing modules (e.g., more focus on metacognitive variables, particularly on decision confidence as one of the primary targets of treatment) and the creation of new modules addressing mood, as well as attempts to improve sustainability of effects via homework exercises and a smartphone app ( www.uke.de/mct_app ). We have also enhanced dissemination efforts by creating new culturally sensitive language versions and facilitating low-threshold training through e-learning courses ( www.uke.de/e-mct ). Finally, we discuss several meta-analyses on the efficacy of MCT that have been published over the last decade. While reviews were initially inconsistent, possibly reflecting the insufficient statistical power and lower design quality of the first MCT studies, more recent meta-analyses have confirmed the efficacy of MCT on positive symptoms, insight, and cognitive biases, which has led to the inclusion of MCT in some national treatment guidelines for schizophrenia.

AB - This article provides an overview and retrospective on metacognitive training for psychosis (MCT), which first appeared approximately 2 decades ago. We recount how our empirical understanding of psychosis at that time led to the first preliminary version of the program. We describe setbacks and challenges that led to major changes, including revisions to existing modules (e.g., more focus on metacognitive variables, particularly on decision confidence as one of the primary targets of treatment) and the creation of new modules addressing mood, as well as attempts to improve sustainability of effects via homework exercises and a smartphone app ( www.uke.de/mct_app ). We have also enhanced dissemination efforts by creating new culturally sensitive language versions and facilitating low-threshold training through e-learning courses ( www.uke.de/e-mct ). Finally, we discuss several meta-analyses on the efficacy of MCT that have been published over the last decade. While reviews were initially inconsistent, possibly reflecting the insufficient statistical power and lower design quality of the first MCT studies, more recent meta-analyses have confirmed the efficacy of MCT on positive symptoms, insight, and cognitive biases, which has led to the inclusion of MCT in some national treatment guidelines for schizophrenia.

KW - Humans

KW - Retrospective Studies

KW - Cognitive Behavioral Therapy

KW - Psychotic Disorders/therapy

KW - Schizophrenia/therapy

KW - Metacognition

KW - Treatment Outcome

U2 - 10.1007/s00406-022-01394-9

DO - 10.1007/s00406-022-01394-9

M3 - SCORING: Review article

C2 - 35338378

VL - 273

SP - 811

EP - 817

JO - EUR ARCH PSY CLIN N

JF - EUR ARCH PSY CLIN N

SN - 0940-1334

IS - 4

ER -