Many relatives caring for someone experiencing psychosis, display high levels of psychological distress. This can result in poorer mental health for both the carer and patient. Negative symptoms have been shown to especially hamper recovery, although little is known about their development and maintenance. Jansen et al. (2014) found greater metacognitive ability in the caregiver can improve coping and reduce distress in caregivers of those with FEP. This study explores the relationship between caregiver experience and metacognitive ability in those with multi-episodic persistent psychosis, exploring if caregivers with greater metacognitive ability have reduced levels of distress and whether there are indicators that negative symptoms are developed and maintained in a relational context.