Recovery-focused Metacognitive Interpersonal Therapy (MIT) for adolescents with first-episode psychosis

Access to evidence-based early intervention for adolescents with psychosis is critically important. The aim of this work was analysing the feasibility, acceptability and potential effects of a psychological intervention based on metacognitive interpersonal therapy (MIT) in adolescents presenting with early psychosis. Twenty-three participants (aged 14–18) experiencing first-episode psychosis or an at-risk mental state for psychosis were offered up to 40h of individual MIT over a 12-month period. Effect sizes were calculated for changes in subjective recovery experience (primary outcome), psychotic symptoms (secondary outcome), and metacognition (hypothetical mechanism of change) from baseline to treatment end. At study completion, 21 out of 23 (91.3%) participants had received twelve or more sessions of MIT. The average number of MIT treatment sessions received was 31 (range 12–40). Large effect sizes were observed for changes in subjective recovery, self-reflectivity, understanding others’ minds, mastery, and emotional distress. Medium effect sizes were observed for changes in negative, positive, and disorganized symptoms. This is the first study to suggest that MIT is both acceptable to young people experiencing early psychosis and is associated with improvements in subjective recovery, symptoms, and metacognition. Despite study limitations, evidence of MIT feasibility, acceptability and potential effects was sufficient to warrant further investigation.