Subjective Experience and Perceived Benefits in Clients with Schizophrenia Following Participation in Metacognition Reflection and Insight Therapy (MERIT)

Abstract

Schizophrenia spectrum disorders involve disturbances in the experience of the self, which are related to limited metacognitive ability. The aim of metacognition-based therapies is to improve metacognitive ability and, subsequently, self-management and recovery. Adding to the quantitative findings from a trial on the effectiveness of Metacognition Reflection and Insight Therapy (MERIT), in the current study, we report on a qualitative assessment of MERIT’s subjective perceived contribution. Twenty-seven patients with schizophrenia were interviewed after completing MERIT. Content analysis based on grounded theory was conducted by two independent raters. Most participants were satisfied with the therapy and reported improvement mainly in self-experience domains. The main contributors to perceived improvement pertained to the intervention process (e.g., therapeutic alliance and therapist interventions) as well as to the patient being an active agent of change. Perceived outcomes are particularly important among this cohort, as they often cope with limited metacognitive abilities, expressed by challenges in reflecting on themselves and others. The current study supports MERIT as a treatment that enhances positive outcomes for people with schizophrenia.