Metacognitive Therapy in Treatment-Resistant Psychosis: A Multiple-Baseline Study

Paul Hutton, Anthony P Morrison, Melissa Wardle, Adrian Wells

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: More effective psychological treatments for psychosis are required. Case series data and pilot trials suggest metacognitive therapy (MCT) is a promising treatment for anxiety and depression. Other research has found negative metacognitive beliefs and thought-control strategies may be involved in the development and maintenance of hallucinations and delusions. The potential of MCT in treating psychosis has yet to be investigated. Aims: Our aim was to find out whether a short number of MCT sessions would be associated with clinically significant and sustained improvements in delusions, hallucinations, anxiety, depression and subjective recovery in patients with treatment-resistant long-standing psychosis. Method: Three consecutively referred patients, each with a diagnosis of paranoid schizophrenia and continuing symptoms, completed a series of multiple baseline assessments. Each then received between 11 and 13 sessions of MCT and completed regular assessments of progress, during therapy, post-therapy and at 3-month follow-up. Results: Two out of 3 participants achieved clinically significant reductions across a range of symptom-based outcomes at end-of-therapy. Improvement was sustained at 3-month follow-up for one participant. Conclusions: Our study demonstrates the feasibility of using MCT with people with medication-resistant psychosis. MCT was acceptable to the participants and associated with meaningful change. Some modifications may be required for this population, after which a controlled trial may be warranted.
Original languageEnglish
Pages (from-to)166-185
Number of pages20
JournalBehavioural and Cognitive Psychotherapy
Volume42
Issue number2
Early online date3 Jan 2013
DOIs
Publication statusPublished - Mar 2014

Keywords / Materials (for Non-textual outputs)

  • metacognitive therapy
  • psychosis
  • schizophrenia
  • hallucinations
  • delusions

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