title: The Special Challenges of Psychotherapy with Persons with Psychosis: Intersubjective Metacognitive Model of Agreement and Shared Meaning.
abstract: Agreement between client and therapist is an essential part of the therapeutic alliance. While there are general challenges to the creation of agreement and shared meaning in all psychotherapies, there are specific challenges while working with persons with psychosis. These challenges include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. Here we present a metacognitive intersubjective model as a framework for the understanding and resolutions of these challenges. Copyright © 2016 John Wiley & Sons, Ltd.
  
  
  CONCLUSIONS
  Goal consensus, agreement and shared meaning are essential for a collaborative process and positive outcome in psychotherapy. Challenges to psychotherapy with persons with psychosis include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. In the intersubjective exchange, the concepts of metacognition and empathy can act as a framework for navigating between the possible challenges and the desired shared meaning and agreement.
authors.affiliation: Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
authors.forename: Ilanit
authors.initials: I
authors.lastname: Hasson-Ohayon
authors.affiliation: Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Kravetz
authors.affiliation: Department of Psychiatry, Roudebush VA Medical Center and the Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lysaker
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D006801:Humans; D008297:Male; D000067489:Metacognition; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods*; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy*
keywords: Alliance; Empathy; Intersubjectivity; Metacognition; Psychosis; Psychotherapy