ABSTRACT
The eleventh chapter of the guidebook to Metacognitive Reflection and Insight Therapy (MERIT) describes the sixth of the eight elements, which comprise the basis for MERIT. This is the second of two process elements. Element 6 is concerned with exploring patients’ perceptions of how therapy is having an impact upon them. Stated otherwise, what has changed or is changing in the mind and life of the patient due to engaging in the activities described in the first five elements of MERIT? How do patients think about themselves or others differently? What are they able to do that they did not or could not do previously? This element calls for reflection and joint consideration of what has taken place in therapy. This may center on a long-term goal or something that has just arisen in the session. It might also be seen in terms of specific outcomes or unexpected or less concrete things. The intent of this element is to encourage therapists to stimulate patients’ metacognition about the experience of therapy and see themselves as purposive beings. Satisfactory adherence to this element requires discussion of the progress within the session along with consideration of what has caused the progress.
