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Restoring Trust for People With Psychosis Through Psychotherapy
Jeremy M Ridenour1, Jay A Hamm, Courtney N Wiesepape2
1Erikson Institute for Education, Research, and Advocacy, Austen Riggs Center, Stockbridge, Massachusetts.
The Journal of Nervous and Mental Disease
|March 27, 2024
Summary
Mistrust in psychosis hinders treatment engagement. Restoring trust involves therapist openness, honest disclosure, and promoting metacognition to build stronger patient-therapist bonds.
Area of Science:
- Psychiatry
- Psychology
Background:
- Mistrust significantly impedes psychosocial treatment engagement for individuals with psychosis.
- Factors influencing mistrust include attachment disruption, childhood trauma, attributional biases, stigma, and discrimination.
Approach:
- Outlines the developmental trajectory of mistrust in psychosis.
- Reviews the impact of adverse experiences on the capacity to form trusting relationships.
Key Points:
- Therapist openness to patient experience and agenda.
- Therapist honest disclosure to foster dialogue and reflection.
- Promoting metacognition to enhance representations of others' minds.
Conclusions:
- Restoring trust is crucial for effective psychosocial interventions in psychosis.
- Metacognitive reflection and insight therapy offer a framework to address mistrust.
- Focus on metacognition and intersubjectivity facilitates trust restoration.
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