Metacognitive training

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Metacognitive Training for Psychosis (MCT) is a new approach to treating so-called positive symptoms of schizophrenia , v. a. Delusion . The training is based on the theoretical principles of behavioral therapy for schizophrenia, but focuses in particular on problematic thinking styles or thinking distortions that are associated with the development and maintenance of positive symptoms.

background

Metacognition , in short, means "thinking about thinking". As part of the training, distorted thinking should be uncovered and corrected. Current studies suggest a connection between distorted thinking, such as jumping to conclusions , and the development and maintenance of psychoses . Accordingly, a correction of the problematic thinking styles should bring about a reduction in the symptoms.

effectiveness

The MKT was included in the treatment guidelines for schizophrenia of the Australian and New Zealand Psychiatry Societies in 2016 ( “evidence-based treatment” ). The German Society for Psychiatry, Psychotherapy, Psychosomatics and Neurology ( DGPPN ) and the German Society for Psychology ( DGPs ) also recommend the MKT for the treatment of schizophrenia / psychosis. The last two meta-analyzes reported a significant effect in favor of MCT compared to control conditions for the treatment of madness and thus confirmed a meta-analysis by Eichner and Berna (15 studies). An earlier meta-analysis by van Oosterhout et al. (3–9 studies per parameter) initially found a weak but non-significant effect in favor of MCT, which became significant after more recent data were included. The oldest meta-analysis by Jiang et al. was carried out in only four studies and found a significant effect for the positive symptoms in general, but not for delusions. For all previous studies, however, a direct comparison of MCT with conventional cognitive behavioral therapy is not yet available (2019).

Adjustments for other disorders

The MCT for psychosis was adapted in the following years for various disorders; individual studies are available for borderline, obsession, depression and bipolar disorders.

Individual evidence

  1. ^ S. Moritz, F. Bohn, R. Veckenstedt, B. Hottenrott, T. Woodward; Metacognition Study Group: Metacognitive Training for Schizophrenic Patients (MCT). Manual . 6th edition. VanHam Campus Verlag, Hamburg 2016.
  2. ↑ Steffen Moritz, Christina Andreou, Brooke C. Schneider, Charlotte E. Wittekind, Mahesh Menon: Sowing the seeds of doubt: a narrative review on metacognitive training in schizophrenia . In: Clinical Psychology Review . tape 34 , no. 4 , June 1, 2014, ISSN  1873-7811 , p. 358-366 , doi : 10.1016 / j.cpr.2014.04.004 .
  3. ↑ a b P. A. Garety, D. Freeman: The past and future of delusions research: from the inexplicable to the treatable . In: The British Journal of Psychiatry . tape 203 , no. 5 , November 1, 2013, ISSN  0007-1250 , p. 327–333 , doi : 10.1192 / bjp.bp.113.126953 , PMID 24187067 ( rcpsych.org [accessed February 23, 2017]).
  4. ↑ JH Flavell: Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry . In: American Psychologist . tape 34 , no. 10 , 1979, p. 906-911 , doi : 10.1037 / 0003-066X.34.10.906 .
  5. ↑ Cherrie Galletly, David Castle, Frances Dark, Verity Humberstone, Assen Jablensky: Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders . In: The Australian and New Zealand Journal of Psychiatry . tape 50 , no. 5 , 2016, ISSN  1440-1614 , p. 410-472 , doi : 10.1177 / 0004867416641195 .
  6. ↑ Wolfgang Gaebel, Alkomiet Hasan, Peter Falkai: S3 guideline schizophrenia . Springer, Berlin 2019, ISBN 978-3-662-59380-6 , pp. 419 .
  7. ↑ Tania Lincoln, Anya Pedersen, Kurt Hahlweg, Karl-Heinz Wiedl, Inga Frantz. Hogrefe, 2019, accessed January 1, 2020 .: Evidence-based guideline on the psychotherapy of schizophrenia and other psychotic disorders . Hogrefe, Göttingen 2019, ISBN 978-3-8017-2883-0 , pp. 140 .
  8. ↑ Yu-Chen Liu, Chia-Chun Tang, Tsai-Tzu Hung, Pei-Ching Tsai, Mei-Feng Lin: The Efficacy of Metacognitive Training for Delusions in Patients With Schizophrenia: A Meta-Analysis of Randomized Controlled Trials Informs Evidence-Based Practice . In: Worldviews on Evidence-Based Nursing . tape 15 , no. 2 , 2018, ISSN  1545-102X , p. 130–139 , doi : 10.1111 / wvn.12282 ( wiley.com [accessed June 19, 2018]).
  9. ↑ Rebecca Philipp, Levente Kriston, Jana Lanio, Franziska Kühne, Martin Härter: Effectiveness of metacognitive interventions for mental disorders in adults — A systematic review and meta-analysis (METACOG) . In: Clinical Psychology & Psychotherapy . tape 26 , no. 2 , March 2019, ISSN  1063-3995 , p. 227-240 , doi : 10.1002 / cpp.2345 ( wiley.com [accessed January 1, 2020]).
  10. ↑ Carolin Eichner, Fabrice Berna: Acceptance and Efficacy of Metacognitive Training (MCT) on Positive Symptoms and Delusions in Patients With Schizophrenia: A Meta-analysis Taking Into Account Important Moderators . In: Schizophrenia Bulletin . tape 42 , no. 4 , 2016, ISSN  1745-1701 , p. 952-962 , doi : 10.1093 / schbul / sbv225 , PMID 26748396 .
  11. ^ B. van Oosterhout, F. Smit, L. Krabbendam, S. Castelein, ABP Staring: Metacognitive training for schizophrenia spectrum patients: a meta-analysis on outcome studies . In: Psychological Medicine . tape 46 , no. 1 , 2016, ISSN  0033-2917 , p. 47-57 , doi : 10.1017 / S0033291715001105 ( cambridge.org ).
  12. ↑ J. Jiang, L. Zhang, Z. Zhu, W. Li, C. Li: Metacognitive training for schizophrenia: a systematic review. In: Shanghai archives of psychiatry. Volume 27, number 3, June 2015, pp. 149–157, doi: 10.11919 / j.issn.1002-0829.215065 , PMID 26300597 , PMC 4526827 (free full text) (review).
  13. ↑ Lisa Schilling, Steffen Moritz, Levente Kriston, Maria Krieger, Matthias Nagel: Efficacy of metacognitive training for patients with borderline personality disorder: Preliminary results . In: Psychiatry Research . tape 262 , April 2018, p. 459–464 , doi : 10.1016 / j.psychres.2017.09.024 ( elsevier.com [accessed January 4, 2020]).
  14. ↑ Steffen Moritz, Lena Jelinek, Marit Hauschildt, Dieter Naber: How to treat the untreated: effectiveness of a self-help metacognitive training program (myMCT) for obsessive-compulsive disorder . In: Dialogues in Clinical Neuroscience . tape 12 , no. 2 , 2010, p. 209-220 .
  15. ↑ Lena Jelinek, Mirjam Faissner, Steffen Moritz, Levente Kriston: Long ‐ term efficacy of Metacognitive Training for Depression (D ‐ MCT): A randomized controlled trial . In: British Journal of Clinical Psychology . December 16, 2018, ISSN  0144-6657 , p. bjc.12213 , doi : 10.1111 / bjc.12213 ( wiley.com [accessed January 4, 2020]).
  16. ↑ Lena Jelinek, Marit Hauschildt, Charlotte E. Wittekind, Brooke C. Schneider, Levente Kriston: Efficacy of Metacognitive Training for Depression: A Randomized Controlled Trial . In: Psychotherapy and Psychosomatics . tape 85 , no. 4 , 2016, ISSN  0033-3190 , p. 231–234 , doi : 10.1159 / 000443699 ( karger.com [accessed January 4, 2020]).
  17. ↑ Paula Haffner, Esther Quinlivan, Jana Fiebig, Lene-Marie Sondergeld, Elisa Sophie Strasser: Improving functional outcome in bipolar disorder: A pilot study on metacognitive training . In: Clinical Psychology & Psychotherapy . tape 25 , no. 1 , January 2018, p. 50-58 , doi : 10.1002 / cpp.2124 ( wiley.com [accessed January 4, 2020]).

Web links

  • link to free versions of metacognitive training (different groups of disorders)