Metacognition, selfexperience and the prospect of enhancing selfmanagement in schizophrenia spectrum disorders

Many contemporary biomedical models of schizophrenia neglect the impact of the meanings that persons with schizophrenia make of their psychiatric and life challenges. This poses problems for conceptualizing methods for enhancing self-management. To address this issue we offer a complimentary model of how schizophrenia involves the disruption of the purposive course of a life and also of the ability to form the kinds of integrated ideas about oneself and others needed to form and sustain the kinds of behavior required for effective self-management. We then introduce the construct of metacognition as a means to operationalize some of the disruptions in the ability to form and use complex ideas about the self and others, ultimately affecting self-experience. We discuss the implications of research on metacognition for self-management in schizophrenia and we discuss six different qualities that interventions focused on self-management of schizophrenia should embrace.