{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:10Z","timestamp":1792787710637,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Expanding expertise Through E-health Network Development (EXTEND) Quality Enhancement Research Initiative","award":["QUE HX0003205-01"],"award-info":[{"award-number":["QUE HX0003205-01"]}],"id":[{"id":"https:\/\/ror.org\/03cdz5d08","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Occupational Therapy"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Metacognitive Reflection and Insight Therapy for Occupational Therapy (MERIT-OT) is a novel adaptation of an evidence-based psychotherapy model designed to enhance metacognitive capacity and support recovery. Its philosophical alignment with occupational therapy\u2014particularly the emphasis on meaning-making and life participation\u2014makes it a promising intervention for Veterans with serious mental illness. However, to date no implementation studies of MERIT-OT have been conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the implementation of MERIT-OT within a Veterans Affairs (VA) occupational therapy setting and to explore preliminary findings regarding clinical effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Pilot study evaluating the implementation and preliminary effectiveness of MERIT-OT when delivered by occupational therapists in a VA setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>One VA Medical Center across four occupational therapy practice areas: psychosocial rehabilitation, outpatient mental health, home health, and women's health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Five occupational therapists; three implemented MERIT-OT with nine Veterans over 37 sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes and Measures<\/jats:title>\n                    <jats:p>Implementation outcomes were assessed using the Consolidated Framework for Implementation Research when analyzing interviews and chart review data. Clinical outcomes were measured using the Metacognition Assessment Scale\u2013Abbreviated (MAS-A).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Facilitators included perceived relative advantage and tension for change. Barriers included competing priorities and documentation challenges. Quantitative analysis showed early gains in metacognitive mastery; other subscales showed limited change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Preliminary findings suggest ongoing consultation, additional training, and improved tools and resources may facilitate MERIT-OT implementation in VA outpatient mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What This Article Adds<\/jats:title>\n                    <jats:p>MERIT-OT offers a structured, recovery-oriented approach aligned with occupational therapy values and shows promise for enhancing metacognitive outcomes in mental health settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19437676261464048","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:23:51Z","timestamp":1783927431000},"page":"827-836","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of Metacognitive Reflection and Insight Therapy for Occupational Therapy (MERIT-OT) to Support Veterans Receiving Occupational Therapy Mental Health Services"],"prefix":"10.1177","volume":"80","author":[{"given":"Sally","family":"Wasmuth","sequence":"first","affiliation":[{"name":"VA Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indiana University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Randolph","sequence":"additional","affiliation":[{"name":"VA Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Triplett","sequence":"additional","affiliation":[{"name":"Durham VA Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anya","family":"Kamara","sequence":"additional","affiliation":[{"name":"Women's Health- Mental Health Occupational Therapist at Durham Veteran Affairs Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie M.","family":"Rehling","sequence":"additional","affiliation":[{"name":"Durham VA Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison L.","family":"Taylor","sequence":"additional","affiliation":[{"name":"General Mental Health-Garner Durham VA Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Bunch","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Karan","sequence":"additional","affiliation":[{"name":"Durham VA Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/frhs.2025.1580653"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718000855"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000865"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g3725"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-016-0437-z"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781315447001"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2043808718814992"},{"key":"e_1_3_2_11_1","first-page":"245","volume-title":"Metacognition and severe adult mental disorders: From research to treatment","author":"Lysaker P. 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