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Metacognitive Therapy in Treatment-Resistant Psychosis: A Multiple-Baseline Study

  • Paul Hutton (a1), Anthony P. Morrison (a1), Melissa Wardle (a1) and Adrian Wells (a2)

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.

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Corresponding author

Reprint requests to Paul Hutton, Psychosis Research Unit, Department of Psychology, Greater Manchester West Mental Health NHS Foundation Trust, Bury New Road, Prestwich M25 3BL, UK. E-mail: paulhutton@nhs.net

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Metacognitive Therapy in Treatment-Resistant Psychosis: A Multiple-Baseline Study

  • Paul Hutton (a1), Anthony P. Morrison (a1), Melissa Wardle (a1) and Adrian Wells (a2)
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