ABSTRACT
The fifteenth chapter of the guidebook to Metacognitive Reflection and Insight Therapy (MERIT) describes the parameters of this unique treatment. MERIT is primarily an office-based intervention, though it can be modified and used in the community. The early middle and later phases of MERIT are described and distinguished from one another. Methods for introducing MERIT to patients and obtaining informed written consent are detailed. Material on length of treatment, rates of change, and termination are also presented. MERIT is also described as an approach that requires ongoing supervision. Four common therapist reactions to learning MERIT are presented. First, MERIT therapists often become comfortable with uncertainty present at the outset of every session. Second, MERIT therapists often become better able to avoid feeling guilt for not “fixing” patient problems or anxious that there is something that they should be doing in addition to attempting to understand the patient. Third, MERIT therapists often learn to manage the distress that comes from fully appreciating the degree of destruction that has been wrought in the patient’s life. Fourth, MERIT therapists often report becoming more aware of aspects of the human condition and themselves that they had either not previously noticed or had warded off.
