Metacognitive interventions for adolescents with mental disorders: a scoping review

Mental disorders among adolescents are increasing globally, yet access to tailored, evidence-based treatments remains limited. Metacognitive interventions, which target thinking processes influencing emotional regulation and behaviour, have shown promise in adults but remain underexplored in adolescents. This scoping review aimed to map and summarise metacognitive interventions for adolescents (aged 10-19) with mental disorders, examining intervention types, targeted disorders, delivery methods, and reported outcomes.

Following JBI methodology for scoping reviews, comprehensive searches of published and grey literature were conducted across multiple databases. Reference lists of included full-text articles and relevant reviews were also screened.

Twenty-three studies published between 2004 and 2024 were included, most from Europe. Interventions identified included Metacognitive Therapy, Metacognitive Training, Metacognitive Interpersonal Therapy, Metacognitive Reflection and Insight Therapy, Virtual Environment Training with metacognitive components, and the Teen Cognitive-Functional Intervention. These were primarily applied to anxiety, depressive, psychotic, and personality disorders. Delivery formats varied (individual, group, family-inclusive), with most interventions delivered face-to-face in outpatient settings.

Findings demonstrate the acceptability and feasibility of metacognitive interventions for adolescents, but also highlight gaps, including limited research on certain disorders, inconsistent outcome measures, scare exploration of digital formats and underexamined contextual factors such as family and school involvement.

This is the first scoping review to map metacognitive interventions for adolescents with mental disorders, addressing a gap in literature predominantly focused on adults. It synthesizes evidence on metacognitive intervention types, delivery formats, clinical contexts, and outcomes, indicating that these interventions are feasible, acceptable, and safe for adolescents. The review identifies important research gaps, including under-studied disorders, methodological limitations, limited investigation of digital delivery formats, and insufficient examination of contextual factors such as family and school involvement, guiding future research and practice.