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Supervision in the Psychotherapy of Schizophrenia: Awareness of and Mutual Reflection upon Fragmentation

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Abstract

Historical and newly emerging models of schizophrenia suggest it is a disorder characterized by the fragmentation of the experience of the self and the world, leading to the interruption of how a unique life is unfolding in the world. It has been proposed that psychotherapy might therefore promote recovery by facilitating the development of a greater ability to integrate information about the self and others. In this paper we explore how the supervision of a metacognitively-oriented psychotherapy can assist therapists to experience and conceptualize fragmentation within sessions, join patients in the gradual process of making sense of their psychiatric problems and life challenges, and ultimately envision and achieve recovery. Common challenges and responses within supervision are described and discussed.

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Authors and Affiliations

  1. Richard L Roudebush VA Medical Center, Indianapolis, IN, USA

    Paul H. Lysaker

  2. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA

    Kelly D. Buck

  3. School of Psychological Sciences, University of Indianapolis, Indianapolis, IN, USA

    Michelle L. Pattison

  4. Chillicothe VA Medical Center, Chillicothe, OH, USA

    Rhianna E. Beasley

  5. Midtown Community Mental Health, Indianapolis, IN, USA

    Jaclyn D. Hillis & Jay A. Hamm

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  1. Paul H. Lysaker
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Correspondence to Paul H. Lysaker.

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Paul H. Lysaker, PhD, Richard L Roudebush VA Medical Center, Indianapolis IN; Department of Psychiatry, Indiana University School of Medicine, Indianapolis IN, USA.

Kelly D. Buck, PMHCNS-BC, Richard L Roudebush VA Medical Center, Indianapolis IN.

Michelle L. Pattison, MA, School of Psychological Sciences, University of Indianapolis, Indianapolis IN.

Rhianna E. Beasley, MA, School of Psychological Sciences, University of Indianapolis, Indianapolis IN.

Jaclyn D. Hillis, PsyD, Chillicothe VA Medical Center, Chillicothe OH.

Jay A. Hamm, PsyD, Midtown Community Mental Health, Indianapolis IN.

Address correspondence to: Paul H. Lysaker, PhD, Richard Roudebush VA Medical Center 116a, 1481 West 10th St., Indianapolis IN 46202, USA. Email: plysaker@iupui.edu

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Lysaker, P.H., Buck, K.D., Pattison, M.L. et al. Supervision in the Psychotherapy of Schizophrenia: Awareness of and Mutual Reflection upon Fragmentation. Am J Psychoanal 79, 284–303 (2019). https://doi.org/10.1057/s11231-019-09198-y

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