“Having a place in the world”: psychotherapy, the therapeutic relationship, and recovery from an episode of schizophrenia

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Background Currently, recovery from an episode of schizophrenia is a feasible goal and can be seen as a psychological development process that enables individuals to regain well-being and manage their own lives. Multiple authors have highlighted the importance of psychological recovery after a schizophrenic episode, a perspective that has redefined the role of psychotherapy in the comprehensive treatment of psychotic episodes. Furthermore, studies on psychotherapy in patients diagnosed with schizophrenia have shown that the therapeutic alliance is a key factor in treatment adherence and recovery, leading to better therapeutic outcomes. However, research focused on reconstructing the establishment and consolidation of the therapeutic relationship is limited, and it does not specify which aspects of the relationship support this connection. This study aims to explore the formation and consolidation of the therapeutic relationship in the psychotherapy of individuals who have experienced a schizophrenic episode, incorporating both patients’ and therapists’ perspectives.Methods This article presents a multiple-case qualitative study, based on grounded theory, involving 11 patient-therapist dyads.Results The interviewees’ narratives highlight the challenges patients face in establishing relational trust.Discussion This condition affects the time required to consolidate the therapeutic relationship and calls for the therapist to be particularly sensitive to the patient’s need for distance.