Effects of the Japanese Version of Metacognitive Training on Self-Efficacy and Sense of Coherence in Community-Dwelling Patients with Schizophrenia: A Pilot Study

Improving self-efficacy, sense of coherence (SOC), and functional stability is essential for recovery and sustained community functioning among individuals with schizophrenia. However, the impact of the Japanese version of Metacognitive Training (MCT-J) on these factors has not been fully examined. This pilot study used a non-randomized Pre-Post design with sequential allocation (not a randomized controlled trial) and included 20 community-dwelling individuals diagnosed with schizophrenia, with 10 participants each assigned to the MCT-J intervention and delayed intervention control groups. To evaluate intervention effects, assessments were conducted using the Self-Efficacy for Community Life Scale (SECL), the Japanese version of Antonovsky's 13-item Sense of Coherence scale (SOC-13), the Beck Cognitive Insight Scale (BCIS), and the Trail Making Test-Japanese version (TMT-J) Parts A and B. Within-group and between-group comparisons assessed the changes in scores and task completion times. In addition, outcomes were examined exploratorily pre-intervention, post-intervention, and at the one-year follow-up among available participants who had received MCT-J. In between-group comparisons, compared with the delayed-intervention control group, the intervention group showed more favorable changes in SECL scores and TMT-J Part A completion time than the control group. At the one-year follow-up, reductions in TMT-J Part A completion times relative to baseline were observed exploratorily among participants who had received MCT-J. These findings support the feasibility of implementing MCT-J in community settings and suggest preliminary benefits for self-efficacy and attentional performance, whereas changes in SOC were limited and exploratory. Although MCT-J may support recovery-related psychological resources in community-dwelling individuals, these preliminary findings should be interpreted with caution, and confirmation in a larger randomized controlled trial is warranted.