MERIT Psychotherapy
MERIT (Metacognitive Reflection and Insight Therapy) is a manual-based psychotherapy designed for people in recovery from schizophrenia and other forms of severe mental illness.
Developed by Paul Lysaker, PhD and colleagues, MERIT is a flexible treatment model that can be used by clinicians working from diverse orientations who are interested in helping clients to improve their recovery-oriented metacognitive capacities.
Metacogntion
At its simplest, metacognition is "thinking about thinking." It includes the mental processes people use to reflect upon and form ideas about themselves and others, make sense of the challenges they face, and decide how to respond to them.
Recovery
In the context of severe mental illness, recovery refers both to the process of growth, through which individuals enhance their mental health, wellness, and overall quality of life, and the measurable outcomes related to this such as symptom reduction, improved functioning, and increased subjective well-being. As a recovery-oriented psychotherapy, MERIT is concerned with both the internal processes and tangible outcomes associated with recovery.
MERIT and Recovery
MERIT supports recovery by helping individuals make sense of their experiences and regain a sense of personal agency and self-determination. MERIT asks clinicians to assess an individual’s metacognitive capacities during sessions and tailor therapeutic interventions aimed at enhancing them. This reflective work facilitates a deeper understanding of the client's difficulties and how they might be addressed.
Empirical Support
A substantial body of research supports the efficacy of MERIT in helping individuals diagnosed with serious mental illness. Evidence includes randomized controlled trials, open clinical trials, qualitative studies, and in-depth case reports. There is also a robust literature documenting the impact of metacognitive impairments in serious mental illness, further underscoring the importance of a clinical focus on metacognition.
