Dialogue therapy in psychosis: A philosophical-ethical approach

Theoretical and empirical work is needed to adapt psychotherapy to psychosis. The article introduces dialogue therapy (DT), a philosophical-ethical, humanistic, and dialogue-oriented individual psychotherapy model for schizophrenia and other severe psychosis. Rather than introducing novel methods, DT offers a unified approach, including flexible methodology derived from existing psychotherapy traditions that focuses on difficulties of emotion, relation, identity, and self-regulation that are characteristic in psychosis. The patient is included to participate fully in the dialogue with her/his subjective voice. The therapist is aware, authentically committed, respectful, and takes seriously all forms of utterances. DT invites the patient to a collaborative process, where she/he is acknowledged as a co-researcher in a continuous search for a cure. Crucial in the therapeutic interaction is to collaborate in generating a breakthrough to split off the psychotic symptoms. The context of DT, therapeutic interactions, and specific methods of how to carry out this psychotherapy are outlined in the article. Not applying psychotherapy in the treatment of psychosis might endanger the development of emotions and self-regulation, social competences, and healthy functioning.