Pilot Study to Evaluate the Effectiveness of Online Familiar Metacognitive Training (MCTf) (MCTf)

Pilot Study to Evaluate the Effectiveness of Online Familiar Metacognitive Training (MCTf) in Mothers With Psychosis and Their Adolescent Children

Parc Sanitari Sant Joan de Déu, Hospital de Sant Pau, Institut Pere Mata, Parc Taulí Hospital Universitari, Hospital de Mataró, Centre d'Higiene Mental Les Corts, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Hospital del Mar, Hospital Universitario Marqués de Valdecilla, Hospitales Universitarios Virgen del Rocío, Fundació Vidal i Barraquer, Hospital Sant Joan de Deu

The objective of this study is to adapt and evaluate the efficacy of Familiar Metacognitive Training (MCTf) in mothers and adolescent children in a group context with the main purpose of improving family relationships, cognitive awareness and symptoms of women with psychosis and the knowledge of the disease by the children. Secondary objectives: to evaluate the improvement in metacognition and social cognition, symptoms, protective factors and self-perception of stigma.

This is a randomized clinical trial will be carried out in which a group of mothers with psychosis and their adolescent children (between 12 and 18 years old) will receive the MCTf online and the other group will receive the treatment as usual. In total, 48 mothers and their children will be recruited from a total of 11 adult mental health care centers. Mothers will be evaluated with cognitive insight scales, other metacognitive and social cognition scales, symptoms, family and social functioning, protective factors (self-steem, resilience, and coping strategies) and self-perceived stigma. The adolescent children will be evaluated with symptoms, metacognition and social cognition, family and social functioning, knowledge of the mother´s illness and protective factors scales. The will be assessed at 2 times: baseline and post-therapy. The Metacognitive training is a group psychological intervention that has demonstrated its efficacy in improve symptoms, insight, metacognition and cognition in people with psychosis. Our hypothesis is that MCTf will be help the adolescents to better understand their mother´s thoughts and their understanding of metacognition and, consequently, to decrease anxiety and depressive symptoms.Furthermore, the investigators expect an increase in familiar and social functioning, as well as in protective factors such as: self-steem, resilience and coping strategies.

Parrallel Assigment. This is a randomized clinical trial in which some patients receive the MCTf intervention and others treatment as usual

Metacognitive training for psychosis. The MCTf consists of 11 therapeutic units developed during weekly sessions lasting 45 and 60 minutes. Each unit contains abundant therapeutic material that includes psychoeducational information, exercises and case examples.The group will be composed of 3-4 mothers with psychosis and her adolescent children and two therapists. The application of the intervention will be by a secure videoconfering method.

The original metacognitive training program consist of 8 therapeutic units and 2 complementary. Seven of the therapeutic units address cognitive deviations and errors that are frequently seen in problem solving in schizophrenia, involved in the formation and maintenance of delusions. The other three units work with metacognition and the aims of the progra, as a psychoeducation session, so in total the MCTf will include 11 sessions.

This scales is a self-registering measure of 15 items. It has 2 dimensions:self-reflection and self-certaintly. A compound index of cognitive insight is obtained as the substraction of self-certaintly from self-reflection.Range 0-45. Higher values represent a better outcome.

This scales is a self-registering measure of 15 items. It has 2 dimensions:self-reflection and self-certaintly. A compound index of cognitive insight is obtained as the substraction of self-certaintly from self-reflection.Range 0-45. Higher values represent a better outcome.

Scale for the assessment of the most cognitive biases in psychosis.Higher values represent more biases.

Scale for the assessment of the most cognitive biases in psychosis. Higher values represent more biases.

Scale for the assessment to the Jumping to conclusions bias. 3 tasks will be included. JTC is considered if the decision is taken before the third ball.

Scale for the assessment to the Jumping to conclusions bias. 3 tasks will be included. JTC is considered if the decision is taken before the third ball.

IPSAQ, Internal, personal and situational Attributions Questionnaire.(Bentall et al., 1991; Diez-Alegria, 2006)

IPSAQ, Internal, personal and situational Attributions Questionnaire.(Bentall et al., 1991; Diez-Alegria, 2006)

20 photographs that express ten basic and ten complex emotions. Possible range 0-20. Higher values representa better outcome.

20 photographs that express ten basic and ten complex emotions. Possible range 0-20. Higher values representa better outcome.

The scale asses the degree of satisfaction of the person with their life in 5 items. Self-administered.

The scale asses the degree of satisfaction of the person with their life in 5 items. Self-administered.

The scale assess awareness of illness in people with schizophrenia, according to the evaluator´s vision

The scale assess awareness of illness in people with schizophrenia, according to the evaluator´s vision

Questionnaire to explore personal self-esteem understood as feelings of personal worth and self-respect. The scale consist of 10 items.

Questionnaire to explore personal self-esteem understood as feelings of personal worth and self-respect. The scale consist of 10 items.

The scale includes 8 scales that assess the frequency of use of primary coping strategies and the perception of coping self-efficacy.

The scale includes 8 scales that assess the frequency of use of primary coping strategies and the perception of coping self-efficacy.

The self-report includes a 28-item test that measures 5 types of maltreatment - emotional, physical, and sexual abuse, and emotional and physical neglect.

Inclusion Criteria: Presence of one of the following diagnoses according to DSM-V criteria: schizophrenia, unspecific psychotic disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder, schizophreniform disorder. Mother of one o more adolescent (12-18 years old). Psychopatological stability in the previous 3 months.(without medication changes). Exclusion Criteria: Head injury or intellectual disabillity (premorbid IQ <=70) Present scores on the PANSS >= hostility, lack of cooperation or suspiciousness, to guarantee a good relationship in the group. Patients with substance dependence disorder. Inclusion/exclusion criteria of adolescents are: 1.age between 12 and 18 yerars old, 2. interested in the group. Exclusion criteria: Head injury or intellectual disabillity (premorbid IQ <=70).