ABSTRACT
The fourteenth chapter of the guidebook to Metacognitive Reflection and Insight Therapy (MERIT) describes the last of the eight elements, which comprise the basis for MERIT. As in the case of the seventh element of MERIT, the eighth element is considered to be a superordinate element because it is concerned with therapeutic action across the whole of the session, regardless of the element or content. Element 8 enables therapists to jointly reflect with patients about the use of metacognitive knowledge to respond to psychological and social challenges in a way that is metacognitively accessible to the patient. It allows therapists to appreciate the level of fragmentation of patients’ experiences and understand the kinds of thoughts that can be shared productively and in time lead to the incremental growth in patients’ metacognitive capacity. This chapter outlines how to use the MERIT-IF Mastery scale to generate interventions appropriate to patient metacognitive levels. Satisfactory adherence to this element requires frequent stimulation of patients to think about the use of metacognitive knowledge to respond to psychological and social challenges, which are more often than not at the appropriate metacognitive level.
