Metacognition Reflection and
Insight Therapy: MERIT is a science-based psychotherapy for



MERIT (Metacognitive Reflection and Insight Therapy) is a manual-based model of psychotherapy designed for people in the process of recovery from schizophrenia and other forms of severe mental illness.

Developed by Paul Lysaker, PhD and colleagues, MERIT is a model of psychotherapy amenable to clinicians working from a variety of orientations who are interested in helping their clients to improve their metacognitive capacities.

Basic Premises

  • Metacognition is the ability to form integrated ideas about one’s self and others and to use that capacity to respond to life challenges.
  • Metacognitive deficits observed in schizophrenia and other severe mental illnesses interfere with the ability to make sense of one’s life and to chart a course to recovery.
  • MERIT’s intent is to help clients to form more integrated ideas about themselves and others with the goal of increasing their ability to respond more adaptively to social and psychological challenges and ultimately live their lives in a richer and more rewarding way.

Psychotherapy Model

MERIT uses the therapy relationship as a self-exploratory platform to help clients to recognize and integrate the range of personal experiences including memories, hopes, dreams, emotions, and beliefs and integrate them into more complex ideas about self and others.

MERIT stresses the use of targeted psychotherapy interventions tailored for the client’s current level of metacognitive functioning. This is guided by the use of a formal assessment of the client's level of metacognitive ability in treatment sessions.

MERIT supports the use of thoughtful and creative therapist behavior because it is based on integrative principles, not step-by-step procedures or a predetermined course of treatment.

Manualized and Research-Based

While flexible, MERIT is a formalized treatment approach. MERIT treatment manuals and assessment tools as well as psychotherapy training and ongoing clinical supervision are available to qualified mental health practitioners.

MERIT is currently the focus of a randomized controlled clinical trial.

Learn More

More information about MERIT can be found in the FAQs and in a downloadable PDF

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