An efficacy study of a metacognitive group intervention for people with schizophrenia

Abstract

Poor cognitive outcomes among people with schizophrenia are associated with poor function in daily life. Cognitive interventions aimed at improving function lead to better cognitive outcomes, but the question of generalization to real-world functioning remains relevant. The ability to generalize or to apply learned skills in the clinic to everyday functioning must include metacognitive components which are the underlying mechanisms of function. To address such generalization, we developed a metacognitive group intervention based on Toglia's (2005) dynamic interactional model, which aims to promote daily activities and participation by focusing on metacognitive components. We assessed 84 participants with schizophrenia (41 in the control group and 43 in the intervention group) before and after completing the intervention and at a 12-week follow-up. Assessments addressed executive function, performance, and participation. The intervention group's performance, participation, and everyday functions significantly increased post-intervention and at follow-up, compared with the control group. Results provide important information about the potential for change in real-world functioning and a basis for the rationale of employing metacognitive interventions in this population.

Keywords: DIM; Dynamic interactional model; EF; Executive functioning; Metacognition; Metacognitive intervention; Schizophrenia.