The recovery of metacognitive capacity in schizophrenia across 32 months of individual psychotherapy: A case study

It has been asserted that psychotherapy might help persons with schizophrenia to improve their capacity for metacognition, that is, their ability to think about their own thinking and the thinking of others. To explore this issue, metacognitive capacity, delusions, and insight were assessed using the psychotherapy transcripts of an adult with schizophrenia and severe delusions for a period of time spanning 32 months. Correlations revealed that metacognitive capacity increased as symptoms and lack of insight decreased. Results suggest that metacognitive capacities increased before symptoms changed and that awareness of one's own thoughts emerged before awareness of others' thoughts. Progress appeared to be initially volatile, with early gains sustained only after approximately 1 1/2 years.