One consistent attitude matched to the behavior
Attitude therapy prescribes a single staff attitude that every team member uses with a client, chosen according to the client's main behavior. Consistency is the active ingredient: when all staff respond in the same way, the client receives a clear and predictable message. This 35-year-old man has persecutory delusions, watches staff closely, and refuses to sit near them. A suspicious client is given passive friendliness: staff remain available and friendly but let him set the pace of contact.
Why passive friendliness fits a suspicious client
A person who believes others intend to harm him experiences approach as threat. Seeking him out, offering help before he asks, or sitting close increases his distrust and anxiety and may provoke defensive aggression. Passive friendliness communicates interest and acceptance without pressure: staff greet him, stay nearby at a comfortable distance, keep promises, and wait for him to approach. Over time this predictability allows trust to develop.
| Client behavior | Prescribed attitude |
|---|
| Withdrawn, apathetic | Active friendliness |
| Suspicious, distrustful | Passive friendliness |
| Depressed | Kind firmness |
| Manipulative | Matter-of-fact |
| Assaultive or acting out | No demand |
Why the other attitudes do not fit
Active friendliness, in which staff seek the client out and offer help freely, is prescribed for withdrawn, apathetic clients who need encouragement to engage. Kind firmness is prescribed for depressed clients, who benefit from clear, confident expectations that reduce indecision. A matter-of-fact attitude, casual and without special attention, is prescribed for manipulative clients so that manipulation is not rewarded. None of these suits a client whose main problem is distrust.
Watch out! With a suspicious client, also avoid whispering or laughing near him, keep explanations simple and honest, and do not argue with the delusion. Offer sealed or self-served food if he fears poisoning.
Exam takeaway
Key point! Attitude therapy pairs behaviors with attitudes: withdrawn with active friendliness, suspicious with passive friendliness, depressed with kind firmness, manipulative with matter-of-fact. The whole team uses the same attitude consistently.