What is it about?

Metacognitive Reflection and Insight Therapy (MERIT) is a psychotherapy that focuses on personal recovery and allows clients to explore their own needs and challenges without a pre-determined agenda. The current paper aims to describe: 1) the development of Metacognitive Reflection and Insight Therapy (MERIT) and 2) how MERIT advances care for persons with SMI by offering an adaptable and flexible approach. MERIT utilizes a metacognitive framework and interpersonal approach to collaboratively decide, between patient and therapist, what to focus on. MERIT training has been successfully completed in multiple countries across different levels of training with professionals such as psychologists and social workers.

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Why is it important?

MERIT is a psychotherapy for people with SMI that allows persons to determine their own wishes and agendas for psychotherapy. It does not require individuals to know yet what recovery means, and allows space for people to negotiate this with their therapist. MERIT is evidence-based, and has been successfully implemented in a variety of settings with differing professionals. MERIT offers a new approach that can be offered to individuals at all stages of recovery and with varying goals.


This article is very special to me, as it is one of the last papers I had the pleasure to write with the late Paul Lysaker, who founded MERIT. I hope to continue Dr. Lysaker's legacy in the important work to promote MERIT and offer a psychotherapy that allows people to choose their own path to recovery.

Laura Faith
Richard L. Roudebush VAMC

Read the Original

This page is a summary of: Psychotherapy to emphasize self-directed recovery for persons with serious mental illness: Contributions from metacognitive reflection and insight therapy (MERIT)., Psychological Services, May 2024, American Psychological Association (APA),
DOI: 10.1037/ser0000865.
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