The Shared Field: A Precursor Stage in the Development of a Psychotherapeutic Alliance with the Hospitalized Chronic Schizophrenic Patient

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Abstract
Psychotherapeutic work with chronic schizophrenic patients is difficult for both patient and therapist. Such patients lack many of the capacities necessary to participate in psychotherapy: motivation, observing ego, the ability to communicate verbally about thoughts and feelings, the capacity to sustain a relationship. Treatment of such patients may require phases in which such capacities are nurtured until the patient is able to form a therapeutic alliance of the ordinary kind. This paper discusses the ways in which hospitalization can be helpful during pre-alliance phases of psychotherapeutic work, through the provision of a protected setting and a team approach, in conjunction with individual psychotherapy. A perspective is offered for conceptualizing the early relationship between patient and hospital staff as a stage in the development of an alliance.

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