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Targeting Insight in First Episode Psychosis: A Case Study of Metacognitive Reflection Insight Therapy (MERIT)

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Abstract

One aspect of schizophrenia contributing to its complexity is the lack of insight individuals often have into their illness. While poor insight is prevalent throughout the course of the illness, more severe levels are associated with first-episode psychosis (FEP). Interventions addressing insight are necessary but current treatments have been shown to have limited effectiveness. Thus, a novel intervention, Metacognitive Reflection and Insight Therapy (MERIT), is being studied for its efficacy of improving insight in individuals with schizophrenia spectrum disorders. MERIT is an integrative metacognitive therapy consisting of eight elements to assist clients in improving their ability to form complex ideas about themselves and others and to use this knowledge to respond to psychological problems. The present study is a case illustration of the implementation of MERIT to improve insight in FEP. Clinical outcomes were assessed and results showed that the client improved in both metacognition and insight. With replication, these results suggest that integrative metacognitive psychotherapy may serve as an intervention that improves insight in FEP, which marks an important step toward improved interventions for individuals with psychosis.

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Acknowledgment

This study was funded by the Brain and Behavior Research Foundation: NARSAD Young Investigator Grant (Award Number: 20936).

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Authors and Affiliations

  1. Department of Psychiatry, Indiana School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA

    Bethany L. Leonhardt, Kelsey Benson & Jenifer L. Vohs

  2. Indiana University Psychotic Disorders Program, Larue D. Carter Memorial Hospital, 2601 Cold Springs Rd, Indianapolis, IN, 46222, USA

    Bethany L. Leonhardt, Kelsey Benson & Jenifer L. Vohs

  3. Prevention and Recovery Center, Eskenazi Health/Midtown Community Mental Health, 720 Eskenazi Ave, Indianapolis, IN, 46202, USA

    Bethany L. Leonhardt, Kelsey Benson & Jenifer L. Vohs

  4. School of Psychological Sciences, University of Indianapolis, 1400 E Hanna Ave, Indianapolis, IN, 46227, USA

    Sunita George

  5. Roudebush Veteran Affairs Medical Center, 1481 W. 10th Street, Indianapolis, IN, 46202, USA

    Kelly D. Buck

  6. Indiana University-Purdue University Indianapolis, 355 E Lansing St, Indianapolis, IN, 46202, USA

    Rheannan Shaieb

Authors
  1. Bethany L. Leonhardt
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  2. Kelsey Benson
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  3. Sunita George
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  4. Kelly D. Buck
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  5. Rheannan Shaieb
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  6. Jenifer L. Vohs
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Corresponding author

Correspondence to Bethany L. Leonhardt.

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Conflict of Interest

Bethany Leonhardt, Kelsey Benson, Sunita George, Kelly Buck, and Rheannan Shaieb have no conflicts of interest to declare. Jenifer Vohs is the recipient of the grant that funded this research (Funder: Brain and Behavior Research Foundation: NARSAD Young Investigator Award, # 20936) and has no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Leonhardt, B.L., Benson, K., George, S. et al. Targeting Insight in First Episode Psychosis: A Case Study of Metacognitive Reflection Insight Therapy (MERIT). J Contemp Psychother 46, 207–216 (2016). https://doi.org/10.1007/s10879-016-9332-9

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  • DOI: https://doi.org/10.1007/s10879-016-9332-9

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