I vividly remember my first experience providing psychotherapy for a patient with psychotic symptoms. In fact, not only was this patient my first with psychosis, but they were my first individual therapy patient ever. As a practicum student at a partial hospitalization program, I was caught off-guard when my patient endorsed auditory hallucinations during an initial intake. Thoughts and doubts such as “I don’t know what I’m doing” and “Could I make my client’s symptoms worse?” flooded my mind.
Ultimately, it was a rewarding experience, and I enjoyed bearing witness to my client’s growth, impressive resilience and resolve. However, there are many things I wish I had known ahead of this first experience. Therefore, this article aims to use my experience as a reference point to provide a brief snapshot of important domains to consider when treating psychosis for the first time.