Metacognitive Reflection and Insight Therapy for Persons With Severe Negative Symptoms of Schizophrenia

Individuals with schizophrenia possess enduring deficits that limit their capacity for interpersonal connection. Negative symptoms of schizophrenia provide additional barriers to interpersonal relatedness in that they include a range of deficits related to an individual’s ability to express and experience emotions—basic human capacities that are needed for daily functioning and an acceptable quality of life. Additionally, metacognitive deficits are closely related to the development and maintenance of negative symptoms; previous research has indicated that treatment of negative symptoms should focus on providing interventions that target metacognition. To explore this issue, a case study is presented in which ongoing assessments of metacognition were used to guide the selection of interventions. These interventions were selected to match the client’s capacity for metacognition at that time and were aimed toward practicing and increasing development of metacognitive capacity. Improvements in function and metacognitive capacity are reported, and implications for research and theory are discussed.