For professionals working with people who experience severe psychosis, increasing
empirical evidence for the benefits of psychotherapy for psychosis has been
especially welcome. Given the limitations of medication-only approaches and
the need for an expanded perspective, including for those diagnosed with schizophrenia,
Surviving, Existing, or Living takes a fresh look at severe psychosis, offering
a heuristic model for understanding psychosis along a continuum of severity,
from the extreme experience of acutely impairing psychosis to a more enriched
Pamela Fuller emphasizes that facilitating recovery from psychosis requires appropriately and effectively matching the type and timing of interventions to client readiness and capabilities. The need to consider each individual according to which of three primary issues/phases preoccupy the person with psychosis is essential for tailoring treatment. She identifies these phases as:
Surviving Phase – preoccupation with survival
Existing Phase – preoccupation with restriction of life experiences in order to cope
Living Phase – preoccupation with quality of life and relationships
Surviving, Existing, or Living examines the rationale for these three phases,
and provides details of phase-specific treatment interventions as well as a
'how to' guide for facilitating engagement and for determining 'what to do when,'
including with those experiencing acute, severe psychosis. Rich clinical case
examples are provided to highlight concepts and the types of interventions.
Trauma-specific and group interventions for psychosis are also described, as
well as ways to foster resilience in the professional who works with individuals
Surviving, Existing, or Living offers a detailed guide to help individuals experiencing psychosis move from suffering to recovery, beyond surviving or existing toward more fully living. The book will be essential reading for professionals in the fields of psychology, psychiatry, counseling, medicine, social work, nursing, occupational, recreational, and vocational therapies, experience-based experts, and students.
Introduction. The Three Phases of Severe Psychosis: Surviving, Existing, and Living. The Surviving Phase: Characteristics and Care. The Existing Phase: Characteristics and Care. The Living Phase: Characteristics and Care. Incorporating Trauma Treatment Into Care for Psychosis. Phase-Specific Group Therapies. Building the Clinician’s Psychological Stamina. Conclusions and Future Directions. References.
Pamela R. Fuller is a clinical psychologist with extensive experience working across the continuum of care with children, adolescents, and adults who have severe psychological problems. She is currently in private practice in Evanston, Wyoming, USA.