Therapy in psychosis appeared to be aimed at enhancing clients' functioning in the social world. In an effort to achieve this, it seemed that clients engaged in an ongoing effort to manage the impact of psychosis on both their subjective experience and on day to day life. The conceptualisation of this effort as an active, ongoing, and individually-directed process was consistent with other examinations of service user accounts.
Building bridges to observational perspectives summarizes the core process in psychological therapy in psychosis. Therapy in psychosis is understood as intimately linking the social and internal world in a dialogical process aimed at enhancing the client's functioning in the social world rather than at specifically developing the private mental experience of reflexivity or mentalizing.
The central activity of therapy in psychosis was understood as a dialogical process continuously negotiated between therapist and client in conversation and was conceptually summarized in the grounded theory as 'building bridges to observational perspectives'. However, the active and strategic efforts of psychologists to sustain the dialogue implied a particular assumption of responsibility for maintaining this process. In particular, therapists appeared to be 'working to maintain observational perspectives', 'managing emotion', and 'doing relationship' during the therapy conversation as part of the joint effort with clients to build bridges to new observational perspectives on distress and psychosis.
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