Ilanit Hasson-Ohayon

Bar Ilan University | BIU · Department of Psychology

Background Disrupted metacognition is implicated in development and maintenance of negative symptoms, but more fine‐grained analyses would inform precise treatment targeting for individual negative symptoms. Aims This systematic review identifies and examines datasets that test whether specific metacognitive capacities distinctly influence negativ...

Homework assignments, or specific tasks patients are asked to engage in or complete between sessions, are a controversial topic among psychoanalysts. While many argue these interventions contradict psychoanalytic principles, others believe they can help address problems and promote coping skills. We propose that homework can be a legitimate aspect...

Self-stigma is associated with a variety of negative self-perceptions among people coping with schizophrenia, as well as with different aspects of social behaviors. We explored the associations between self-compassion, self-esteem, social anxiety, and self-stigma among people coping with schizophrenia. The baseline data of 56 adults with schizophre...

There is limited evidence available to utilize in making treatment decisions for individuals with schizotypy. Existing treatments may include pharmacological or skill-based interventions; however, these approaches often seem to neglect self-experience and personal recovery. Metacognitive reflection and insight therapy (MERIT) is a recovery-oriented...

Objective: Although the clinical significance of the therapeutic alliance (TA) is well documented, the literature regarding the establishment of TA and the relation between client-therapist agreement on it to short-term outcome among various diagnostic groups-and specifically among clients diagnosed with serious mental illness (SMI)-is sparse. The...

Background: Prolonged grief disorder (PGD) was recently approved as a formal diagnosis in the DSM-5-TR. The implementation of bereavement interventions is frequently requested, but their effectiveness has been controversial. Narrative reconstruction (NR) is a time-limited integrative therapy, originally developed for the treatment of post-traumati...

Purpose: Negative symptoms are a persistent, yet under-explored problem in psychosis. Disturbances in metacognition are a potential causal factor in negative symptom development and maintenance. This meta-analysis uses individual participant data (IPD) from existing research to assess the relationship between negative symptoms and metacognition tr...

In schizophrenia spectrum disorders, improvement in symptoms varies between patients with short and long durations of illness. In this meta-analysis we provided an overview of both short-and long-term symptomatic improvement for patients with schizophrenia spectrum disorders with distinct durations of illness. We included 82 longitudinal studies as...

Background: Research has suggested that people diagnosed with schizophrenia experience challenges in their abilities to reflect upon themselves, others and their actions in the world. One emerging approach to addressing these forms of subjective disturbance is Metacognitive Reflection and Insight Therapy (MERIT). Aims: In this study, a randomize...

Objective: This study applies the Actor-Partner Interdependence Model (APIM) to explore the associations between disclosure and concealment with depression and anxiety among patients with cancer and their partners. Method: 90 patient-spouse dyads completed the Self-Disclosure Index (SDI), the Self-Concealment Scale (SCS), the Couples Illness Sel...

Hospitalization of children in an inpatient psychiatric ward is stressful for both the children and their parents, and separation from the parents during hospitalization is probably one major cause of this stress. We designated one room in a closed inpatient unit to enable a parent to stay with his/her child, including overnight, during the 1st wee...

Homework assignments in psychoanalysis are contentious; some believe they contradict psychoanalytic principles, while others argue they enhance coping skills. We propose that homework can be a legitimate aspect of relational psychoanalysis when used in a way that is attuned to the patient’s experience and that homework may be an important component...

Background: Impaired cognitive insight and increased self-stigma have been consistently reported in individuals diagnosed with schizophrenia spectrum disorders, but little is known about its presence in individuals at ultra-high risk of developing a psychosis, although self-stigma is associated with transition.to psychosis. The current study exami...

Background: Difficulties in emotion regulation (ER) abilities have been found to play a central role in different psychiatric disorders. However, researchers rarely compare ER across different diagnostic groups. In the current study, we examined ER and its relation to functional and symptomatic outcome among three distinct diagnostic groups: peopl...

This systematic review focuses on personality traits according to both the Five Factor Model and Cloninger Psychobiological Model in relation to treatment related outcome variables across all stages of clinical psychotic illness. Search of Pubmed and Psychinfo databases led to final inclusion of 65 studies, which were ranked on quality and analyzed...

Background Receiving the label of a psychotic disorder influences self-perception and may result in negative outcomes such as self-stigma and decreased self-esteem. The way the diagnosis is communicated to individuals may affect these outcomes. Aims This study aims to explore the experiences and needs of individuals after a first episode of psycho...

Background and aim There are growing concerns about the long-term effects of psychiatric medication after a major psychiatric crisis. Recent evidence shows a diverse impact of long-term use on various outcome domains, which may help explain why non-adherence is so common. In the current study we explored the subjective perceptions of factors that i...

Background: COVID-19 is an ongoing global crisis, with a multitude of factors that affect mental health worldwide. We explored potential predictors for the emergence and maintenance of depression, anxiety, and posttraumatic stress symptoms (PTSS) in the general population in Israel. Methods: Across the span of 16 months, 2478 people completed a...

Narrative reconstruction is a time-limited integrative therapy, originally developed in the context of post-traumatic stress disorder and adjusted for the treatment of prolonged grief disorder (PGD). It consists of exposure to the loss memory and narrating a detailed written reconstruction of it. In this paper, we describe narrative reconstruction...

Objective: Immediate therapist self-disclosure (Im-TSD) can be a powerful intervention. When engaged in judiciously, it can provide clients with a unique opportunity to explore their interpersonal relationship in real time. Relational theories suggest that for Im-TSD to be effective, both client and therapist must have temporally congruent percepti...

Objectives: In this study, we assessed the patient-oncologist relationship, conceptualized as the working alliance from a dyadic perspective, and its relation to locus of control. Methods: One hundred and three oncologist-patient dyads were recruited. Measures included a sociodemographic and medical questionnaire; the "internal, powerful others,...

Mothers coping with a serious mental illness often face familial, social, and cultural barriers that challenge their identity as a mother and hinder their recovery process. Research has shown that enhancing a positive coherent multidimensional sense of self and sense of mastery promote recovery. To further explore this possibility, the current pape...

Background Research suggests that in-session emotional experiences in psychotherapy promote both session and treatment outcomes across different clinical samples and treatment approaches. However, little is known about how this notion applies to clients with schizophrenia, who experience particular deficits related to emotional experience. To explo...

People experiencing severe mental illness who are forced to be hospitalized due to an acute condition do not often agree with the method of treatment offered to them in psychiatric wards. Metacognitive Reflection and Insight Therapy (MERIT) is an integrative form of psychotherapy that helps therapists focus together with their patients on thinking...

Objective: The narrative enhancement and cognitive therapy (NECT) intervention aims to reduce self-stigma among people with severe mental illness. Based on previous studies that showed the intervention's beneficial outcomes, we conducted an uncontrolled pilot study of NECT in the Netherlands to assess both feasibility in delivering NECT and outcom...

Extensive literature addresses the correlates of communication behaviors within couples in the specific stressful context of oncology. This literature focused mainly on the concepts of disclosure, concealment, holding back and protective buffering to gain more insight into the potential benefit of open communication on the psychological and relatio...

Objective: The current meta-analysis investigates the efficacy of psychotherapy during psychiatric hospitalization and examines the moderating role of diagnosis and therapeutic approach. Methods: We conducted systematic searches in literature databases, including PubMed, PsycInfo, and Google Scholar. In total, 37 samples were included for the me...

Child loss may undermine one’s faith. Whereas much is known about religion’s role following loss, less is known about the experience of divine struggle—namely, struggling with complex God-related emotions/beliefs—particularly among diverse sociocultural samples. Employing a narrative approach, we interviewed 20 bereaved Modern-Orthodox parents. Ana...

Objective: To identify COVID-19 work-related stressors and experiences associated with sleep difficulties in HCW, and to assess the role of depression and traumatic stress in this association. Methods: A cross-sectional study of HCW using self-report questionnaires, during the first peak of the pandemic in Israel (April 2020), conducted in a lar...

Background The COVID-19 pandemic is an ongoing global crisis, with a multitude of factors that affect mental health worldwide. Here, we explore potential predictors for the emergence and maintenance of depression, anxiety, and posttraumatic stress symptoms (PTSS) in the general population in Israel. Methods Across the span of 16 months, 2,478 peop...

The oncology setting may give rise to significant feelings of helplessness among oncologists via patients’ inevitable deaths or suffering. The current study examines whether and how oncologists’ sense of control (locus of control; LOC) influences their compassion fatigue and satisfaction. Methods: Seventy-three oncologists completed the following q...

Coping with a child’s psychiatric disorder involves various challenges for parents that can result in family burden. One factor related to family burden, which has been examined in previous studies, involves the interaction of the parent with the child diagnosed with the disorder. The current study, expanding on this notion, examined the interactio...

The current study longitudinally examined the moderating effects of consuming different types of media (i.e., formal – news; and informal – social media, WhatsApp) in the association between COVID-19 related worries, intolerance of uncertainty (IU) and post-traumatic stress symptoms (PTSS). Data were collected at two time points during July and S...

In this meta-analysis we investigated changes in social functioning and its moderators in patients with a psychotic disorder but different durations of illness at baseline. We included longitudinal studies assessing the course of five domains of social functioning in patients with a psychotic disorder. Effect sizes of change between baseline and fo...

Hospitalization due to COVID-19 bears many psychological challenges. While focusing on infected patients, their relatives are being largely neglected. Here, we investigated the mental health implications of hospitalization among relatives over a one-month course. A single center study was conducted to assess relatives of COVID-19 patients during th...

Abstract: Psychopathology is often studied, and treated, from an individual-centered approach. However, studies have shown that psychological distress is often best understood from a con-textual, environmental perspective. This paper explores the literature on emotional contagion and symptom transmission in psychopathology, i.e., the complex ways i...

Introduction: Social functioning is often impaired in the ultra-high-risk (UHR) phase of psychosis. There is some evidence that empathy is also impaired in this phase and that these impairments may underlie difficulties in social functioning. The main aim of this study was to investigate whether cognitive and affective empathy are lower in people i...

Growing appreciation of the impact of social cognition deficits on social functioning among people with serious mental illness (SMI) has led to the development of interventions that target them. The purpose of the present study was to conduct a qualitative analysis of the effectiveness of two group interventions, social cognition and interaction th...

Many with psychosis experience substantial difficulties forming and maintaining social bonds leading to persistent social alienation and a lack of a sense of membership in a larger community. While it is clear that social impairments in psychosis cannot be fully explained by symptoms or other traditional features of psychosis, the antecedents of di...

Growing awareness that many who are diagnosed with schizophrenia recover has spurred the development of new psychosocial approaches to treatment. These new approaches include forms of individual and group psychotherapy whose focus extends beyond reducing symptoms and improving skills to subjective outcomes related to sense of self. This paper intro...

BACKGROUND There is limited data on the longitudinal trajectories of psychiatric disorders in children with cancer and risk factors for their persistence. The current study aimed to longitudinally assess the trajectories and risk factors for anxiety and depressive symptoms and disorders in children and adolescents with cancer. METHODS Children and...

Metacognitive reflection and insight therapy (MERIT) is an integrative form of psychotherapy which seeks to help adults with serious mental illness make sense of the psychosocial challenges and possibilities they face and decide how to respond to them and direct their own recovery. In this article, we present an adaptation of MERIT to the context o...

In this volume, the collected chapters have described approaches to the treatment of psychosis that have shifted their focus from symptom reduction and skill acquisition to helping persons make their own sense of the challenges they face and how to manage them. While many different approaches have been presented, we suggest that these chapters offe...

Emerging evidence from studies on the subjective experience of recovery from psychosis indicates that mental health services need to move beyond seeking to reduce symptoms or promote skill acquisition. Wellness, as it is increasingly defined in terms of mental health, recognizes that services need to take into account the sense people make of the c...

Objective: To investigate which factors and processes facilitated disengagement from mental health services (MHS). Method: The study adapted the narrative approach to the life stories method. We interviewed 13 women and 10 men who were diagnosed with a serious mental illness (SMI) for which they were hospitalized and used medication in the past but...

Objective: The beliefs that people with psychosis hold about causes of their illness (causal beliefs) can affect their choice to adhere to treatment and engage in mental health services. However, less is known about causal beliefs of mental health professionals (MHPs) and their impact on treatment adherence and service engagement. This review expl...

Despite treatment guidelines recommending antipsychotic medication (APM) as the frontline treatment for schizophrenia, its use remains a controversial topic, and nonadherence rates range between 40% and 60%. At the heart of the debate lies a divergence of views about the tradeoffs between side effects and efficacy, particularly over the long term....

In recent years, accumulating evidence has pointed to the possible negative effects of cannabis use in social and interpersonal context. In this study, we explored the association between level of cannabis use and perceived social support and the extent to which social network size and diversity may mediate this association. Data from the NESARC-II...

Objectives: To promote functional recovery in persons diagnosed with a psychotic disorder, vocational interventions have emerged over the last few decades which range from sheltered employment to supported employment in the community. Design: Using data from a 6-month vocational rehabilitation programme, we examined whether assessments of the th...

Background: Prolonged grief disorder (PGD) is a chronic and disabling condition that affects approximately 10% of non-traumatically bereaved people. Narrative reconstruction (NR), originally designed for the treatment of posttraumatic stress disorder (PTSD), is a time-limited integrative therapy consisting of exposure to the loss memory, detailed w...

We describe the attitudes of child psychiatrists toward diagnosis delivery (DD) and explore potential stressful factors associated with the process. Eighty Israeli child psychiatrists completed a questionnaire on their perceptions of DD of schizophrenia, autism spectrum disorder (ASD), and attention deficit/hyperactivity disorder (ADHD). We also co...

While the clinical significance of therapeutic alliance with persons with psychosis is well established, the agreement between client and therapist assessments of therapeutic alliance and the longitudinal changes of both assessments has been rarely addressed. The current study examined client and therapist assessments of therapeutic alliance longit...

Shared decision making (SDM) is an interpersonal health communication model that is underutilized with people with serious mental illness. Although research has emphasized the role of patient capacity–, clinician-, and system-related barriers in SDM underutilization, the risk taking that affects SDM with people with mental illness is less often dis...

Background: Healthcare workers (HCW) treating coronavirus disease 2019 (COVID-19) patients face high levels of psychological stress. We aimed to compare mental health outcomes, risk and protective factors for posttraumatic stress symptoms (PTSS), probable depression, and anxiety between HCW working in COVID-19 and non-COVID-19 wards. Methods: A...

Parents of children with psychiatric disorders who are hospitalized in a psychiatric unit often experience family burden. Family burden has been found to be affected by many variables related to parents' personal traits and ways of reacting to the disorder. The current study examined the association between information coping styles (monitoring and...

Objectives Little is known about the mental health outcomes of hospitalized COVID-19 patients. The aims of the study were: (1) to examine the trajectories of anxiety, depression, and pandemic-related stress factors (PRSF) of COVID-19 hospitalized patients one-month following hospitalization; (2) to assess the presence of post-traumatic stress sympt...

Objective: While previous studies have indicated that therapists’ self-disclosure (TSD) can have curative effects, the contextual variables that may moderate the link between TSD and treatment outcome have not been sufficiently explored. Using session-by-session psychotherapy data, we examined the extent to which within-client distress and between-...

The experience of psychosis often involves subtle but pervasive changes in how persons experience themselves and the world. On the other side of the coin, persons also recover from psychosis and these subtle changes are reversed. Metacognitive reflection and insight therapy (MERIT) is an example of one attempt to develop a recovery oriented therapy...

Objective: While previous studies have indicated that therapists’ self-disclosure (TSD) can have curative effects, the contextual variables that may moderate the link between TSD and treatment outcome have not been sufficiently explored. Using session-by-session psychotherapy data, we examined the extent to which within-client distress and between-...

The coronavirus COVID-19 and the global pandemic has already had a substantial disruptive impact on society, posing major challenges to the provision of mental health services in a time of crisis, and carrying the spectre of an increased burden to mental health, both in terms of existing psychiatric disorder, and emerging psychological distress fro...

Although psychiatric rehabilitation has grown dramatically over the last several decades, it remains unclear whether there are general overarching mechanisms of action. One lesser explored possibility is that psychiatric rehabilitation has its long-term effects because of its impact on sense of self. In this special issue authors use the concept of...

Often people diagnosed with schizophrenia have limited information regarding their diagnosis, or they may have stigmatizing ideas about what that diagnosis means. Assimilating psychoeducation into integrative metacognitive psychotherapy can provide opportunities for clients to make sense of what their diagnosis could mean to them and how it fits in...

Background: While focusing on the management and care of COVID-19 patients, the mental health of these patients and their relatives is being overlooked. The aim of the current study was to measure anxiety and depression, and to assess their association with socio-demographic and pandemic-related stress factors in COVID-19 patients and their relativ...

Objective: It has been established that recovery is a common outcome for adults diagnosed with serious mental illness which involves objective and subjective phenomenon. While considerable work has examined objective aspects of recovery, it remains difficult to know how to quantify the processes which support more subjective aspects of recovery re...

Background: Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients' and therapists' estimations of TA among clients with severe disturbances, while focusing on two potential mod...

Coronavirus outbreak created diverse challenges for mental health services in general and to psychotherapy in particular. One of the most prominent of these is the move from delivering psychotherapy in face to face sessions to telephone or internet-based platforms. While this is a challenge to all psychotherapies, this paper examines specific consi...

Objective: Research on the psychological toll of the COVID-19 pandemic is being conducted in various countries. This study aimed to examine risk factors for mental health problems among Israeli adults during this crisis. Methods: 204 participants took part in the study. They completed self-report questionnaires assessing perceived stress, anxiety,...

Although empirically supported treatments for posttraumatic stress disorder (PTSD) exist, many patients fail to complete therapy, are nonresponsive, or remain symptomatic following treatment. This paper presents the results of a delayed intervention quasi-randomized controlled study that evaluated the efficacy of narrative reconstruction as an inte...

Background: While much research has been devoted to examining individual differences in one's interpersonal attachment, very little research has been devoted to examining individual differences in one's attachment to God (ATG). Particularly, how ATG dimensions relate to different religious denominations (RD). Purpose: To explore the relationship be...

Background Reports on the relationship between clinical insight and psychotic symptoms have shown inconsistent results, and the association between clinical insight and personality has rarely been addressed. The aim of this study was to examine whether personality is correlated cross-sectionally with insight level, and longitudinally with change in...

In the past years, ample interest in brain abnormalities related to clinical and cognitive insight in psychosis has contributed several neuroimaging studies to the literature. Published findings on the neural substrates of clinical and cognitive insight in psychosis are integrated by performing a systematic review and meta-analysis. Coordinate-base...

Background Healthy metacognition involves several capacities, including the ability to integrate information about the self and others in order to formulate ways of coping with social challenges and psychological distress. Multiple studies have demonstrated that reduced general metacognitive capacity is predictive of the development and persistence...

This is a commentary on fifteen articles addressing some of the major emergent challenges in provision of mental health services during the COVID-19 pandemic crisis, offering telepsychiatry as a viable and elegant solution to maintaining psychotherapy within and post-pandemic. The papers in the special issue both build on existing telepsychotherapy...

Objective: Metacognition among people with schizophrenia is associated with desired outcomes but can also lead to the experience of psychological pain, affecting the individual's sense of meaning in life. The aim of the current study was to investigate whether the effect of metacognition on meaning in life was dependent on one's level of self-comp...

Objective: Preliminary evidence has found metacognitive capacity is associated with therapeutic alliance and with other outcomes in psychotherapy among persons with schizophrenia. The current study explored: (a) before to after changes in clients' metacognition capacity following Metacognitive Reflection and Insight Therapy (MERIT) and (b) whether...

The coronavirus COVID-19 and the global pandemic has already had a substantial disruptive impact on society, posing major challenges to the provision of mental health services in a time of crisis, and carrying the spectre of an increased burden to mental health, both in terms of existing psychiatric disorder, and emerging psychological distress fro...

Purpose Oncologists cope with unique work characteristics that increase their risk of developing compassion fatigue—that is, burnout and secondary traumatic stress—and can result in reduced capacity and interest in being empathetic to the suffering of others (Stamm B. The concise ProQOL manual, 2010). At the same time, oncologists can experience co...

Recent research has suggested that recovery from psychosis is a complex process that involves recapturing a coherent sense of self and personal agency. This poses important challenges to existing treatment models. While current evidence-based practices are designed to ameliorate symptoms and skill deficits, they are less able to address issues of s...

As research on metacognition has progressed a significant array of definitions, methodologies and therapeutic applications have emerged. Some of this work has primarily framed metacognition as an activity carried out by one person in order to know, monitor, and adjust their beliefs, memories, and behaviors. Accordingly, problems with metacognition...