Get access

Addressing metacognitive capacity for self reflection in the psychotherapy for schizophrenia: A conceptual model of the key tasks and processes

Authors

  • Paul H. Lysaker,

    Corresponding author
    1. Roudebush VA Medical Center, Indianapolis, Indiana, USA
    2. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
      Correspondence should be addressed to Dr Paul H. Lysaker, Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA (e-mail: plysaker@iupui.edu).
    Search for more papers by this author
  • Kelly D. Buck,

    1. Roudebush VA Medical Center, Indianapolis, Indiana, USA
    2. Purdue University School of Nursing, Indianapolis, Indiana, USA
    Search for more papers by this author
  • Antonino Carcione,

    1. Terzo Centro di Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva, Rome, Italy
    Search for more papers by this author
  • Michelle Procacci,

    1. Terzo Centro di Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva, Rome, Italy
    Search for more papers by this author
  • Giampaolo Salvatore,

    1. Terzo Centro di Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva, Rome, Italy
    Search for more papers by this author
  • Guiseppe Nicolò,

    1. Terzo Centro di Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva, Rome, Italy
    Search for more papers by this author
  • Giancarlo Dimaggio

    1. Terzo Centro di Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva, Rome, Italy
    Search for more papers by this author

Correspondence should be addressed to Dr Paul H. Lysaker, Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA (e-mail: plysaker@iupui.edu).

Abstract

Purpose. Recognition that recovery from schizophrenia may involve a deepening of the experience of being in the world has led to the possibility that psychotherapy may play a key role in treatment by enhancing metacognition, or the capacity to think about thinking. While the potential of psychotherapy to enhance metacognition in non-psychotic disorders has been discussed in depth, little has been written about how psychotherapy may systematically address metacognition in schizophrenia. Accordingly, the current paper formulates a model of how psychotherapy might address one specific element of metacognition, namely self-reflectivity.

Methods. Procedures are outlined for assessing clients' capacity for self-reflectivity within narrative contexts during psychotherapy.

Results. Targeted interventions are identified which are tailored to clients' capacities in the moment and which assist clients to think about their own thinking at the level of which they are capable. This may lead clients over time to develop a greater ability to engage in acts of increasingly complex self-reflectivity.

Conclusions. Individual psychotherapy can be modified and utilized to assist persons with schizophrenia to move towards recovery by assisting them to develop the capacity for self-reflectivity. This may lead to clients having a fuller experience of themselves as a being in the world with a richer and more coherent personal narrative.

Get access to the full text of this article

Ancillary