61.3 Group and Individualized Metacognitive Training for Psychosis (MCT, MCT+): Latest Results: on Its Efficacy in the Treatment of Psychotic Symptoms

Abstract

Background: Many studies implicate cognitive biases such as jumping to conclusions, attributional distortions, a bias against disconfrmatory evidence and overconfdence in errors in the pathogenesis of paranoid schizo‐phrenia. Building upon this literature, we developed a group metacognitive training program (MCT), which aims to convey scientifc knowledge on cognitive biases to patients. The MCT provides corrective experiences in an engaging and supportive manner and is available in 33 languages via www. uke.de/mkt. Individualized metacognitive therapy (MCT+) is available in eight languages. Methods: We will present exercises from MCT and MCT+ and present data from the latest randomized‐controlled trials as well as meta‐analyses. Recently, the interventions have been extended and now also address self‐esteem and stigma, as emotional problems are viewed as primary treatment goals by many patients. Results: Meta‐analyses confrm that MCT and MCT+ exert a small to medium effect on delusions, which are partially sustained at follow‐up, and client acceptance is very good. The group format is not effective; however, in patients who present with very severe paranoid symptoms and formal thought disorder. Conclusion: The last 2 decades have witnessed increasing support for psy‐chological models of schizophrenia suggesting that cognitive biases as well as dysfunctional coping styles play an important role in formation and maintenance of the disorder. Psychological intervention should not only be recommended by guidelines but ultimately be integrated into standard care for schizophrenia, especially in view of tempered enthusiasm regarding the benefts of psychopharmacological therapy. We are currently adapting online versions of MCT/MCT+ in order to foster long‐term effects and secure lasting change in patients.