Metacognitive Treatment in Acquired Brain Injury and Its Applicability to Aphasia: A Systematic Review.
Amanda Wadams, Louisa Suting, André Lindsey and 1 others
PMID 36188940WHAT IT FOUND
Metacognitive therapy helped most people with acquired brain injury on at least one measure, but results varied widely.
For those with aphasia, evidence is too thin to recommend it as a standalone treatment. Try breaking goals into steps and giving feedback, but do not expect consistent language gains.
Key findings
01Twenty-eight of the 29 included studies reported positive outcomes on at least one measure, but only 14 studies reported positive outcomes on all measures used.
02For people with aphasia, only 15 participants across five studies were reviewed, and nine of them showed positive language results, which is not enough evidence to conclude benefit.
03Goal Management Training (GMT) was used in three studies with 54 participants and showed consistently positive scores, but this is insufficient to prove it is the most effective treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The studies included had highly variable designs, treatment dosages, and outcome measures, making direct comparison and meta-analysis impossible. Methodological quality was inconsistent; many studies lacked blinding, concealed allocation, or detailed reporting of treatment fidelity. The number of participants with aphasia was very small (15 total across five studies), limiting conclusions for this specific population. Treatment effects were often measured on at least one outcome, but positive results on all measures were rare (only 14 of 29 studies).
Declared interests
The authors declared no commercial or financial conflicts of interest.
The easy way to misread this
Do not assume metacognitive therapy is proven effective for aphasia. The review included only 15 people with aphasia, and the authors explicitly state there is not enough evidence to conclude benefit for this group. Improvements in other ABI populations do not automatically translate to language recovery.