Application of Integrative Metacognitive Psychotherapy for Serious Mental Illness

Recovery for many people with serious mental illness is more than symptom remission or attainment of certain concrete milestones. It can also involve recapturing a previously lost coherent and cohesive sense of self. The authors review several case studies of integrative metacognitive psychotherapy offered to adults with broadly differing clinical presentations. In all the cases, patients demonstrated significant subjective gains and objective improvements—for example, in negative symptoms, in substance use, and in overcoming a history of childhood sexual abuse. By applying this method to various problems—issues consistent with the realities faced in actual clinics—the authors explore how integrative metacognitive psychotherapy is able to address more subjective aspects of recovery by stimulating gains in the experience of agency that lead to the development of more cohesive self-experience, regardless of objective markers of recovery.