Chapter 2.Engaging and Assessing
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Engagement and maintenance of the patient relationship is fundamental to any psychotherapeutic intervention (Wright et al. 2006). If the patient is disengaged and can’t be reached, progress in psychotherapy is impossible. Some patients with severe mental illness who have difficulties engaging may walk out, refuse to talk to you, or only allow very superficial conversation. But, a collaborative CBT approach can help even the most paranoid or cognitively impaired patients work with you to meet the broad goals that they have for their lives. Building a therapeutic relationship with persons with severe mental illness often involves a step-by-step process. Initially, there may be a relatively superficial working relationship. However, continued efforts to promote collaboration can progressively allow for more interaction, disclosure, and change.
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