The therapeutic alliance in cognitive behavioral therapy for psychosis
This chapter focuses on ways in which the therapist can contribute to establishing the therapeutic alliance. It describes aspects of the therapeutic alliance and discusses the challenges to establishing a good alliance in the therapy of psychotic disorders, and how these challenges can be overcome. In clinical practice there are no clear-cut distinctions between engagement, assessment and intervention in psychological interventions for psychosis, with engagement and assessment remaining key therapeutic factors throughout therapy. Throughout the assessment it is crucial to remember that the ultimate goal of the therapist is to try to understand, rather than to try to make the person change their mind by challenging the reality of their voices and delusions. There are a number of advantages to using standardised measures. Such an assessment can be carried out routinely by an assistant clinical psychologist before therapy starts, saving the therapist time, so that they can concentrate on engagement and proceed directly to a Cognitive Behavioural Therapy assessment.