• delusion;
  • delusion severity;
  • metacognitive ability;
  • metacognitive therapy;
  • schizophrenia

Accessible summary

  • Individualized metacognitive training is an effective therapy for reducing delusion severity and at the same time increasing metacognitive ability.
  • Correlations emerged between delusion severity and metacognitive ability was needed to be established.
  • Current research findings on cognitive biases and their link to schizophrenia/delusions are explained in a comprehensible and non-stigmatizing manner to patients and illustrated by multiple (everyday life) examples.


The article is a report of a study conducted to explore the influence of individualized metacognitive therapy (MCT) on delusional severity and metacognitive ability. Delusional beliefs are at the core of schizophrenia. While there is emerging evidence on the usefulness treatment for psychosis of the group training MCT, so far only one study has investigated the effectiveness of individualized metacognitive training. A quasi experimental approach was adopted: The sample consisted of each 26 patients in the intervention group and in the control group. We found that delusion severity as assessed with the Psychosis Rating Scales and metacognitive abilities using the Metacognitive Ability Questionnaire improved significantly in the intervention group. Group differences achieved significance in favour of the MCT for all measures. Correlations that emerged between delusion severity and metacognitive ability were needed to be established. Metacognitive training appears to be effective in decreasing delusion severity and increasing metacognitive ability. We recommend that individualized MCT for a schizophrenic client should become a standard procedure in the treatment of psychosis, which can be administered by a qualified nurse.