“I’d Be A Completely Different Person if I Hadn’t Gone to Therapy”: A Qualitative Study of Metacognitive Therapy and Recovery Outcomes in Adults with Schizophrenia

Abstract

Objective

Metacognitive oriented treatments are novel therapies designed to address metacognition deficits in schizophrenia, defined as the set of mental activities that allows reflection on oneself and others, and the integration of this knowledge into sophisticated mental representations that guide adaptive responses to life’s demands and to the challenges imposed by psychiatric illness. However, little is known about the first-person experiences of engaging in this treatment. Hence, the purpose of this qualitative study was to characterize first-person experiences of recovery outcomes among people with schizophrenia spectrum disorders who take part in metacognitively oriented psychotherapy.

Method

A sample of 13 adult veterans with schizophrenia or schizoaffective disorder in an outpatient setting who were receiving one form of individual metacognitively oriented therapy, Metacognitive Reflection and Insight Therapy, for a minimum of 12 months participated in an open-ended interview; 27 questions probed their experiences with therapy and the outcomes and changes they have observed within themselves as a result. Interviews were analyzed using an inductive consensus based approach.

Results

Findings indicate that participants observed changes in their lives in five recovery domains: improvements in real world functioning, increased formation of life pursuits, enhanced interpersonal connections, emergence of self compassion, and improved quality of life and wellness.

Conclusions

This study sheds further light on first person experiences of people with schizophrenia and adds to the growing body of evidence supporting the use of this form of metacognitively oriented psychotherapy to promote recovery in important life domains.

ACKNOWLEDGEMENTS

No acknowledgements to report.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Marina Kukla

Marina Kukla is a Clinical Psychologist and Research Scientist at the Richard L. Roudebush VA Medical Center in the HSR&D Center for Health Information and Communication and an Associate Research Professor in the Department of Psychology at Indiana University-Purdue University at Indianapolis. She has research and clinical experience focused on approaches that promote recovery in adults with serious mental illness.

Carla Arellano-Bravo

Carla Arellano-Bravo earned an M.D. from Indiana University School of Medicine (IUSM) in 2017 and completed her psychiatry residency training at IUSM in 2021. She is currently a staff psychiatrist at the VA Medical Center in Indianapolis, where she specializes in the treatment of severe mental illness.

Paul H. Lysaker

Paul Lysaker is a Clinical Psychologist at the Richard L Roudebush VA Medical Center and a professor of clinical psychology in the department of psychiatry at the Indiana University School of Medicine. He has over 35 years of experience providing psychotherapy to adults diagnosed with psychosis and has been an author on over 500 peer reviewed publications.