Metacognition, attachment and psychotherapy in first-episode psychosis: a case study

Vergara-Ramirez, Sergio

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dc.contributor.author	Vergara-Ramirez, Sergio
dc.date.accessioned	2023-05-02T19:03:23Z
dc.date.available	2023-05-02T19:03:23Z
dc.date.issued	2023
dc.identifier.uri	http://repositorio.ucm.cl/handle/ucm/4728
dc.description	Aim of the study: Psychotherapy in first-episode psychosis is essential for the recovery of affected users. Those with primary psychotic disorders experience impaired abilities to form complex ideas about themselves and others, called metacognitive deficits. They also present important attachment disturbances. Methods: This paper aims to review the concepts of metacognition and attachment in psychosis, present an interpersonal metacognitive model incorporating elements of attachment theory and analyze a clinical case to show the integration of different strategies in the initial phase of therapy. The Metacognitive Assessment ScaleAbbreviated (MAS-A) was used to assess changes in the user’s metacognitive ability. Results: The therapist adopted the role of secure base and safe-haven to develop an adequate therapeutic relationship, operating through metacommunication and self-participation. Normalization interventions were applied and the user’s agenda was consistently prioritized. The user developed greater metacognitive abilities in the MAS-A along with better functioning, maintained few symptoms and was able to move into a new phase of therapy. Discussion: The review and clinical case presented highlight the importance of an interpersonal metacognitive model that considers the users’ attachment pattern and a solid therapeutic relationship. Hierarchical metacognitive interventions are presented that allowed the user to address more complex psychological conflicts in therapy. Conclusions: Psychotherapeutic models that integrate the concepts of metacognition and attachment theory are promising to improve self-reflective abilities in users with a first-episode psychosis. The clinical case presented would be a contribution to design future studies about these processes.	es_CL
dc.language.iso	en	es_CL
dc.rights	Atribución-NoComercial-SinDerivadas 3.0 Chile	*
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/3.0/cl/	*
dc.source	Archives of Psychiatry and Psychotherapy, 25(1), 14-23	es_CL
dc.subject	Metacognition	es_CL
dc.subject	Attachment	es_CL
dc.subject	Psychosis	es_CL
dc.subject	Schizophrenia	es_CL
dc.subject	Psychotherapy	es_CL
dc.title	Metacognition, attachment and psychotherapy in first-episode psychosis: a case study	es_CL
dc.type	Article	es_CL
dc.ucm.facultad	Facultad de Medicina	es_CL
dc.ucm.indexacion	Scopus	es_CL
dc.ucm.uri	archivespp.pl/Metacognition-attachment-and-psychotherapy-in-first-episode-psychosis-a-case-study,155217,0,2.html	es_CL
dc.ucm.doi	doi.org/10.12740/APP/155217	es_CL