Metacognitive therapy in treatment-resistant psychosis: A multiple-baseline study

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

Abstract

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.

Citation

Hutton, P., Morrison, A. P., Wardle, M., & Wells, A. (2014). Metacognitive therapy in treatment-resistant psychosis: A multiple-baseline study. Behavioural and Cognitive Psychotherapy, 42(2), 166-185. https://doi.org/10.1017/S1352465812001026

• Journal Article Type: Article
• Acceptance Date: Dec 1, 2013
• Online Publication Date: Jan 3, 2013
• Publication Date: 2014-03
• Deposit Date: Dec 15, 2016
• Journal: Behavioural and Cognitive Psychotherapy
• Print ISSN: 1352-4658
• Electronic ISSN: 1469-1833
• Publisher: Cambridge University Press
• Peer Reviewed: Peer Reviewed
• Volume: 42
• Issue: 2
• Pages: 166-185
• DOI: https://doi.org/10.1017/S1352465812001026
• Keywords: Metacognitive therapy, psychosis, schizophrenia, hallucinations, delusions
• Public URL: http://researchrepository.napier.ac.uk/Output/455341