The LORS-enabled dialogue: improving insight in psychotic illnesses

Patients often underestimate the degree of their psychiatric illness and consequently have difficulty effectively participating in interventions to optimize recovery. This problem of insight may be connected with neurological difficulties resulting in poor explicit memory; however, most interventions nurses use to help patients improve their understanding of illness rely on explicit memory. The discrepancy between clinician and patient scores on the Levels of Recovery from Psychotic Disorders Scale (LORS) has been correlated with measures of insight and psychopathology. This difference can be used in a therapeutic dialogue, the LORS-Enabled Dialogue (LED). This intervention engages patients' implicit memory, asking a series of open-ended questions and using motivational interviewing to help promote patients' attainment of life goals. Large-scale studies of this intervention are currently underway and should help better define questions about the effectiveness of the LED.