Table 4.

Risks of using supportive psychotherapy in schizophrenia and strategies for minimizing these risks

RISKS STRATEGY FOR MINIMIZING RISK FOR THE PATIENT

Dangers of inappropriate intensive psychotherapy Get to know patient's capacity for understanding, initially using limited or superficial interpretations

Increased depression, chance of suicide Build in safety by seeking feedback from patient; be able to offer extra support when needed

Premature termination Maintain appropriate distance; avoid overstimulation and intrusion into patient's life before such issues can be handled

COUNTERTRANSFERENCE PROBLEMS

Unrealistic expectations Understand the course and prognosis of the illness, and become knowledgeable about cognitive deficits in schizophrenia

Overly pessimistic expectations Realize that pessimism may be a way of protecting yourself from doubts about your own competency; however, it can become self-fulfilling

Therapist burnout Avoid staking your reputation on any one patient

From Novalis PN, Peele R, Rojcewicz SJ. Clinical Manual of Supportive Psychotherapy. Washington, DC: American Psychiatric Press, Inc., 1993:153.