One of the cardinal features of psychosis is the lack of insight into the condition, though a relative lack of insight into the nature and efects of a set of behaviours or thoughts may be present in other conditions. For instance, a young person's developmental stage will often leave him or her more likely to deny the significance of any symptoms (even if technically the lack of insight associated with a psychosis is not the problem.) This means achieving engagement with the adolescent patient and their network is often far more challenging, as the worker is trying to set up the context for a therapeutic encounter when the patient is denying that he or she has any problems, or at least is resistant to admitting this is a possibility.

Cognitive Behavioural approaches can help to begin the process of gently challenging a densely insightless response to the challenge of mental illness.

Consider a focus on QuickWins, to avoid an over-focus on conflict (see also Roll with Resistance in Motivational Work).