Building bridges to observational perspectives: a grounded theory of therapy processes in psychosis.

OBJECTIVES This study set out to explore therapy processes in psychosis with an initial focus on reflexivity and how this might be expressed in therapy conversations. DESIGN Leiman's (2000) definition of reflexivity was used as a starting-point for an exploratory investigation of the use of language as reflective activity. Grounded theory was chosen as an appropriate methodology to distil an explanatory account across the qualitative data collected. METHOD Six psychologist-client pairs supplied three tapes of therapy sessions spread out across the course of therapy. Each participant was separately interviewed on two occasions to ascertain their views of therapy and of the emerging grounded theory. RESULTS A grounded theory was developed conceptualizing the processes and activities in psychological therapy in psychosis. CONCLUSIONS Building bridges to observational perspectives summarizes the core process in psychological therapy in psychosis. Therapy in psychosis is understood as intimately linking the social and internal world in a dialogical process aimed at enhancing the client's functioning in the social world rather than at specifically developing the private mental experience of reflexivity or mentalizing.

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