The combination of psychotic and substance use disorders compounds the well-documented challenges of treatment engagement, retention, and outcome for these single conditions. This study focuses on the formation of alliance among this important clinical group. Psychologists working on a research trial participated in qualitative interviews focused on their impression of delivering treatment to people with psychotic disorders and concurrent nicotine dependence. Utilizing Interpretive Phenomenological Analysis, the authors highlighted the complex and unusual experience of working with people with psychotic disorders and concurrent nicotine dependence, the importance of considering each client as an individual, and the many layers of interaction between therapist and client. The authors found that meaningful therapeutic relationships over the longer term are possible, even when active symptoms are present. There is also potential for telephone-based treatments to work well. Clinical supervision and support, tailored to the unique experience of therapists working with psychotic populations, is pivotal.

中文翻译：

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与患有精神障碍和同时发生尼古丁依赖的人合作：心理学家对健康生活方式研究试验的态度和反思。

精神病和物质使用障碍的结合加剧了这些单一条件下治疗参与、保留和结果的充分记录的挑战。本研究的重点是在这个重要的临床群体之间形成联盟。从事研究试验的心理学家参加了定性访谈，重点关注他们对精神病患者和并发尼古丁依赖者提供治疗的印象。利用解释性现象学分析，作者强调了与精神病患者和并发尼古丁依赖者一起工作的复杂和不寻常的经历，将每个来访者视为个体的重要性，以及治疗师和来访者之间的多层次互动。作者发现，即使存在活动症状，长期有意义的治疗关系也是可能的。基于电话的治疗也有可能奏效。根据治疗精神病患者的独特经验量身定制的临床监督和支持至关重要。