Intensive psychiatric treatment with emerging adults: Addressing the problem of establishing collaboration

The Compass Program at The Menninger Clinic was designed to assess and treat emerging adult psychiatric patients with severe disorders. Establishing a collaborative therapeutic relationship with these challenging patients is an essential step in facilitating effective assessment and treatment for them. The author presents a therapeutic model for engagement and collaboration. Three interrelated processes that are keys to promoting and creating collaborative behavior are described: (1) taking agency, the ability to accept responsibility for and believe in one's own contribution to solving problems; (2) mentalizing, the ability to reflect on, as opposed to react to, mental states in self and others, as well as to contemplate the issues in one's treatment process, and (3) the ability to examine one's problems from the standpoint of identifying core issues, those internal and external factors that have been impediments to one's progress. Case examples are used to illustrate these processes.