Therapeutic Assessment With First Episode Psychosis: Potential Effects on Treatment Engagement

Date of Award


Document Type

Doctoral Research Paper

Degree Name


Organizational Unit

Graduate School of Professional Psychology

First Advisor

Hale Martin

Second Advisor

Linda Montagna

Third Advisor

Clayton Kuklick


Therapeutic assessment, Psychosis, First-episode psychosis, Psychological assessment, Collaborative assessment


Individuals in the early stages of psychosis disengage from treatment at alarmingly high rates. Approximately 30% of individuals involved in specialized early intervention programs (SEI) for first episode psychosis (FEP) disengage from services despite ongoing therapeutic need (Lal & Malla, 2015). A comprehensive review of literature regarding treatment disengagement for this population found disengagement rates varied from 20.5% to 40% across studies (Doyle, et al., 2014). Current treatment guidelines for early interventions of FEP identify use of a collaborative approach aimed at increasing self-efficacy, enhancing self-beliefs, and improving insight can facilitate higher levels of treatment engagement. Studies also identify the therapeutic alliance and self-awareness of one’s mental health as important predictors of treatment engagement (Anthony et al., 2002; Ruchlewska et al., 2016). Clinical guidelines recommend that clinicians conduct a comprehensive psychological assessment of the individual upon referral to a SEI for FEP (Addington et al., 2013). For many individuals experiencing FEP, this assessment is the first time they engage with mental health services. Emerging research regarding the utility of Therapeutic Assessment (TA), a semi-structured approach to collaborative psychological assessment, offers compelling evidence in support of this approach with FEP. While the field has seen a surge in evidence-based early intervention programs for treatment of FEP, there is a lack of literature available regarding how psychological assessment services may be tailored to increase motivation and engagement. To address this gap in effective service delivery, this paper explores the potential benefits of TA as they relate to treatment engagement among individuals with psychosis. In addition, the author offers some general research suggestions for the proposal of a comparative study that examines the impact of TA on treatment engagement, therapeutic alliance, and self-awareness among individuals in the early stages of psychosis.

Publication Statement

Copyright held by the author. Permanently suppressed.


42 pgs

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