The use of direct confrontation: the treatment-resistant schizophrenic patient.

Schizophrenics are often labeled treatment-resistant because the psychological treatment they receive is seldom appropriate for their needs. Specialized psychotherapy for schizophrenia is available but rarely used. Training in these methods is difficult to find. If we are to treat schizophrenia successfully, we must rethink the treatment and training process, modify our views and teach interventions that force the patient to respond to the demands of the therapist. Professionals must learn that change occurs because the therapist is stronger than the psychotic defenses of the patient, i.e., the patient's resistance to treatment.