Metacognitive training for psychosis (MCT): past, present, and future

Steffen Moritz, Mahesh Menon, Ryan Balzan, Todd S. Woodward

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)
57 Downloads (Pure)


This article provides an overview and retrospective on metacognitive training for psychosis (MCT), which first appeared approximately 2 decades ago. We recount how our empirical understanding of psychosis at that time led to the first preliminary version of the program. We describe setbacks and challenges that led to major changes, including revisions to existing modules (e.g., more focus on metacognitive variables, particularly on decision confidence as one of the primary targets of treatment) and the creation of new modules addressing mood, as well as attempts to improve sustainability of effects via homework exercises and a smartphone app ( We have also enhanced dissemination efforts by creating new culturally sensitive language versions and facilitating low-threshold training through e-learning courses ( Finally, we discuss several meta-analyses on the efficacy of MCT that have been published over the last decade. While reviews were initially inconsistent, possibly reflecting the insufficient statistical power and lower design quality of the first MCT studies, more recent meta-analyses have confirmed the efficacy of MCT on positive symptoms, insight, and cognitive biases, which has led to the inclusion of MCT in some national treatment guidelines for schizophrenia.

Original languageEnglish
Pages (from-to)811-817
Number of pages7
JournalEuropean Archives of Psychiatry and Clinical Neuroscience
Issue number4
Early online date25 Mar 2022
Publication statusPublished - Jun 2023


  • Cognitive biases
  • Metacognitive training
  • Psychosis
  • Schizophrenia
  • Social cognition


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