BackgroundSchizophrenia is a severe mental illness that places a great burden on patients, their families and society. Current psychotherapeutic care for those affected is often insufficient. AimThis review describes Metacognitive Training for psychosis (MCT). MethodFor decades, psychosis was considered inaccessible for psychotherapy. This review article presents the theoretical background of MCT and explains in a practice-oriented way how MCT corrects thought distortions. Information on its implementation and evidence of the effectiveness of MCT are presented. The material is available free of charge in 39 languages (download at www.uke.de/mct). ResultsThe MCT is a low-threshold group intervention for psychosis. The concept is conveyed to patients as "thinking about thinking". The MCT aims to raise patients' awareness of all thought distortions associated with the formation and maintenance of psychosis, with the goal to reduce symptoms. Through playful exercises, participants develop an understanding of dysfunctional thought processes and learn new and more helpful ways of thinking. Topics such as stigma, mood and self-esteem are also addressed. Several meta-analyses have demonstrated the effectiveness of MCT, particularly for positive symptoms but also for negative symptoms and self-esteem. An analysis of extensive data from a multinational project shows that MCT leads to a reduction of the burden caused by delusions and improves impairment in daily life due to hearing voices. ConclusionMCT is an effective and easy to implement intervention based on the principles of cognitive behavioral therapy (CBT) that can contribute to reducing the treatment gap.