In the renewal process of rehabilitation techniques in therapeutic communities, interest raised in new treatments that could evaluate clinical work with severe psychotic patients beyond their high social impairment, poor quality of life and severe symptoms, with the aim of limiting the many prejudices on chronicity. Starting a specific group psychotherapy created the need of focusing the intervention and verifying its efficacy, with special attention both on themes that emerged and the mental processes involved. The Metacognition Assessment Interview (MAI, Semerari et al., 2003) was used to identify the poorest metacognitive abilities, on which we focused our intervention during the psychotherapeutic dialogue. The central aim of our job was the therapeutic action on the individual even in a group psychotherapy. At the end of the therapy, patients showed an improved ability to report the narrative details on which the work was focused. Our observations found a positive feedback in scores for different metacognitive functions, measured before and after the therapy. Comparison of HONOS and PANNS scales seemed to report an improvement in social functioning, with unchanged or reduced symptoms. This experience confirms the possibility to go beyond therapeutic practices that are structured on a single type of chronic patient, and foresees a possible good recovery even in severe and stabilized mental suffering. This is in line with the hypothesis of an heterogeneous ability of mentalization in equal disorders.
Keywords: Psychiatric rehabilitation, psychotic patients, chronicity, metacognition, MAI (Metacognition Assessment Interview), focused treatment.