Enhancing Metacognition Through Group-Based Metacognitive Reflection and Insight Therapy (MERITg)

Serious mental illness, such as schizophrenia, and its sequelae have profound impacts on the life of an individual. In psychosis, the collapse of one’s capacity to form complex ideas about oneself and others leads to an exacerbation of psychiatric symptoms, societal challenges, and a disrupted sense of self, quality of life, sense of purpose, and connection to others. Group-based Metacognitive Reflection and Insight Therapy (MERITg) enhances metacognition, the processes necessary to integrate experience and form complex ideas about the self and others, by building insight through written autobiographical narratives and interactive discussion with others. As demonstrated through the illustrative cases of Michelle and Dameon, this paper outlines both the benefits of providing MERITg in a recovery-oriented framework to support self-directed recovery and the components and techniques of MERITg. Clinical and ethical challenges, and practice considerations are discussed.