Engaging the homeless paranoid patient.
For people who are disenfranchised from society for other reasons, especially homelessness, a paranoid delusional system can create an additional obstacle in the therapeutic engagement and treatment of such individuals. In this article, we describe a composite case of a homeless woman with paranoid schizophrenia. Through this case example, we will explore various obstacles to treatment and discuss strategies to overcome these hurdles to treatment, initiate a therapeutic alliance, and further facilitate and maintain therapy.
Dr. Roman is Associate Professor of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio.
Brenda
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Roman
Gayatri
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Patel