AUTHOR=Balzan Ryan P., Galletly Cherrie 

TITLE=Metacognitive therapy (MCT+) in patients with psychosis not receiving antipsychotic medication: A case study

JOURNAL=Frontiers in Psychology

VOLUME=6

YEAR=2015

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2015.00967

DOI=10.3389/fpsyg.2015.00967

ISSN=1664-1078

ABSTRACT=<p><bold>Background:</bold> Psychotherapies for psychosis typically aim to develop an awareness of the implausible content of a delusion or target the underlying <italic>cognitive biases</italic> (i.e., problematic thinking styles, such as hasty decisions and illusory control) that foster and maintain delusional beliefs. A recently designed individual-based treatment entitled <italic>metacognitive therapy</italic> (MCT+) combines these two approaches. Emerging evidence suggests individualized MCT+, when used concurrently with antipsychotic medication, may be an effective psychological treatment for reducing delusional symptoms. However, it remains to be tested whether MCT+ can be effective in patients with active delusions who are not currently receiving psychotropic drugs.</p><p><bold>Method:</bold> We present two cases (one patient with schizophrenia and the other with delusional disorder) experiencing active delusions who underwent 4-weeks of intensive MCT+, without concurrent antipsychotic medication (minimum 6-months unmedicated). Baseline and 6-week follow-up data are presented on a variety of measures assessing delusion symptom severity (i.e., PANSS, PSYRATS, SAPS), clinical insight, and cognitive bias propensity.</p><p><bold>Results:</bold> After 4-weeks of MCT+, both patients showed substantial reduction in delusional symptoms, reported improved clinical insight, and were less prone to making illusory correlations.</p><p><bold>Conclusions:</bold> The presented case studies provide preliminary evidence for the feasibility of MCT+ in treating patients not taking, or resistant to, antipsychotic medication.</p>