Promoting Affect Regulation Among Individuals Experiencing Psychosis in Metacognitive Reflection and Insight Therapy (MERIT)

Theorists have suggested that individuals experiencing psychosis have significant affective dysregulation, and that expressions of psychosis may in fact serve as one form of expression of painful affect. As such, therapeutic approaches to work with individuals experiencing psychosis may incorporate therapist actions targeted to promote affect regulation in clients. Metacognitive Reflection and Insight Therapy (MERIT) is an integrative approach to psychotherapy that incorporates eight elements to target metacognition among individuals experiencing psychosis. MERIT has been shown to promote improvement in metacognition for persons with psychosis, but little has been done within this framework to explore the therapists' role in promoting affect regulation among individuals experiencing psychosis. This paper discusses how therapist actions related to each of the eight components of MERIT may promote affect regulation in the therapeutic context. Case examples are given to illustrate the application of this approach. Common challenges faced among therapists, limitations, and future directions are also discussed.