Engaging loneliness in the psychotherapy for psychosis

Background People with psychosis experience loneliness at higher rates than the general population and identify loneliness as one of the most significant barriers to personal recovery. While many researchers have called for psychosocial treatments to specifically target loneliness for people experiencing psychosis, there are limited treatment models that provide direct recommendations for therapists working with people with psychosis.Methods A narrative review of the existing empirical and scholarly literature on loneliness in psychosis was conducted, including a review of first-person accounts of how people with psychosis experience loneliness.Results Following this review, four key practice elements are outlined, including addressing barriers to accessing the patient’s longing for connection, the loneliness of psychotic experiences, internalized stigma and its impact on loneliness, and loneliness within the therapeutic relationship, that can serve to reduce loneliness through psychotherapy.Discussion Psychotherapy can be a key intervention to reduce the loneliness that people with psychosis often experience. It may be a crucial first step to build enough trust that may allow people with severe mental illness to then access group and community supports that may enable them to integrate into the wider community.