Incorporating behavioral activation into psychotherapy with persons with psychosis requires adaptation
in its conceptualization and application owing to special deficits in the self-experience. Persons with
psychosis often experience a diminished or disorganized sense of self, and have deficits in coherently
narrating the experience of the self and in the ability to make sense of how to take action and direct their
own lives. Based on a metacognitive model of disability in psychosis, the current paper presents a therapy
process of a woman coping with schizophrenia using Metacognitive Reflection and Insight Therapy
(Lysaker and Dimaggio, 2014) in the framework of an intersubjective model for psychotherapy with
persons with psychosis presented by Hasson-Ohayon, Kravetz, and Lysaker (2016a). The case in point
and its following discussion highlight the important significance of metacognitive encouragement as a
first step of behavioral activation.