The LEAP Method: How to Help a Loved One With Psychosis Get Mental Health Support

The LEAP Method

What Is the LEAP Method?

The LEAP method is a form of communication designed to aid individuals with mental illness, especially those with an absence of insight into their mental health condition.

Dr. Xavier Amador developed the LEAP method from his personal experience with his brother’s schizophrenia and 30 years of work with families and individuals who lack insight into their illness—a condition called anosognosia.

Individuals with mental health problems like schizophrenia are helped by it because it increases motivation for change while providing insight into their mental health condition and strengthening treatment adherence.

What Does LEAP Stand For?

The LEAP method is composed of four steps: Listen, Empathize, Agree, and Partner.

These steps help individuals build trust and cooperation to support and encourage accepting treatment.

How Is LEAP Different From Other Approaches?

The method is different from others because it focuses on the strength of the relationship, not the strength of the argument.

When family members or loved ones use the LEAP method, they guide you toward treatment, which can include psychotherapy and medication—the emphasis on listening, empathizing, agreeing, and partnering fosters a sense of trust and compassion. Communication is essential when using LEAP. At Ocean View, communication is central to everything we do—how we listen, empathize, validate, and stay connected shape treatment, relationships, and recovery outcomes. 

The Evidence Behind LEAP

What Research Supports LEAP and Its Effectiveness?

Several studies, including “Supporting Patients by Family Education in Psychotic Illness: A Longitudinal Pre-Post Study Protocol,” support the LEAP method and its effectiveness.

Furthermore, “A Pilot Study of Listen-Empathize-Agree-Partner (LEAP) With Assertive Community Treatment (ACT) Mental Health Clinicians” examines the method’s reliability when used by community-based clinicians. Additionally, LEAP has been taught at hundreds of LEAP seminars and supported by 25 years of clinical research backed by the :

• NIMG
• Stanley Research Foundation
• Elizabeth K. Dollard Trust
• American Psychiatric Association
• National Alliance on Research on Schizophrenia and Depression

How Have Families and Clinicians Applied LEAP in Real Cases?

Mental health professionals and family members have successfully used the LEAP method in family interventions, peer support, and in clinical settings.

Family members and friends who have employed the method with their loved one employ key skills like:

• Listening
• Empathy

These skills help their loved one feel understood and supported. Additionally, when friends and family use LEAP, it can strengthen their relationship, improve communication, and encourage their loved one to reach out to a mental health provider.

Who LEAP Serves & When to Use It

Is LEAP Appropriate for Loved Ones With Psychosis?

Clinicians and studies that use LEAP have found it is effective for treating those with psychosis.

When used with an individual experiencing psychosis, it can make them feel validated and understood, letting them know their opinion is important.

Can LEAP Be Used for Other Mental Health Conditions?

Yes, LEAP is appropriate for several mental health conditions.

Therapists use LEAP as mental health support for conditions other than schizophrenia and bipolar disorder. The method is used in mental health care for:

• Anxiety disorders
• Depression
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Personality disorders

LEAP can benefit a range of mental health conditions because of its focus on building partnerships and empathy. Caregivers and friends can support their loved one who is experiencing a mental health crisis to seek treatment.

Understanding Anosognosia

What Is Anosognosia and How Does It Relate to Psychosis?

Individuals with anosognosia can’t recognize mental health conditions that are occurring.

When an individual is experiencing anosognosia, their brain doesn’t process or understand what their senses are telling them. Anosognosia prevents individuals with mental health conditions like schizophrenia who are experiencing a psychosis from recognizing their symptoms, which leads to them not taking their medication.

Why Does Anosognosia Make Accepting Help Difficult?

When the brain doesn’t recognize the symptoms of a physical or mental health condition, the individual is unaware they’re experiencing a mental health crisis.

What makes accepting help challenging for those with anosognosia is the lack of communication in the frontal lobe. The lack of awareness of their mental health condition creates a gap between their current mental health status and their past mental health status. The lack of self-awareness can vary throughout an individual’s life, but it does prevent individuals from recognizing the severity of their condition and seeking help.

How Can Understanding Anosognosia Change How I Respond?

Understanding anosognosia helps loved ones respond to their loved one’s mental health condition with patience, respect, and compassion.

Loved ones who recognize that their family member or friend is not in denial but instead is experiencing cognitive impairment. The neurological condition linked to the frontal lobe of the brain prevents them from being self-aware and recognizing their mental health condition.

Recognizing Resistance to Help

When a Loved One Resists Help, What Warning Signs Should I Look For?

Observing a loved one’s behavior can help you recognize the warning signs of a mental health condition or crisis. The key changes to watch for are:

• Behavioral changes
• Emotional changes
• Physical changes
• Cognitive changes

Anosognosia is challenging because a loved one can’t perceive their mental health status, which is why knowing the following warning signs of a mental health issue, such as schizophrenia or bipolar disorder, is vital:

• Feeling of sadness or hopelessness
• Difficulties or changes in daily functioning
• Social isolation
• Changes in eating habits
• Sleep disturbances
• Difficulty focusing
• Heightened sensitivity to sounds or lights

If you notice any of these changes, approach your loved one in conversation using the communication tools in LEAP. Ocean View Mental Health Facility’s medical and mental health professionals use LEAP’s communication method to guide individuals to seek and accept behavioral health treatment.

What Are Common Reasons People With Psychosis Refuse Help?

Often, individuals experiencing psychosis refuse help because they lack the awareness to recognize their symptoms.

They may also refuse help because of the following symptoms:

• Anosognosia
• Fear
• Paranoia
• Suspicion of others

Individuals can also struggle with the fear of being labeled with a mental health condition, fearing change, thinking others are trying to harm them, and thinking their symptoms are normal.

How Can I Tell the Difference Between Deliberate Refusal and Lack of Insight?

The difference between a deliberate refusal and a lack of insight is that a deliberate refusal is a conscious choice to acknowledge a problem or reject help. In contrast, a lack of insight is a neurological condition.

Individuals who refuse to accept help or acknowledge that a problem exists are aware of the problem but choose to ignore it. They may refuse because of:

• Fear
• Stigma
• Personal beliefs

Those who deliberately reject help often offer reasons or arguments for doing so. 

On the other hand, those who lack insight honestly believe they don’t have a mental health condition. They also have an illness that prevents them from recognizing the symptoms or making a healthy choice. The inability to understand and recognize mental health symptoms blocks them from seeing the need for help, or they feel justified in their current state.

Common Things a Loved One Might Say to Refuse Help

What Signs Suggest a Loved One Is Resisting Help?

A loved one who is resisting mental health treatment may deny their mental health condition or the need for treatment.

An individual who refuses to acknowledge they need help can also:

• Withdraw from loved ones
• Vocalize harmful thoughts
• Experience adverse or unusual behaviors
• Exhibit severe mood swings
• Trouble focusing on conversations or tasks

The lack of awareness caused by the neurological issues in the brain’s frontal lobe makes it challenging for an individual to recognize they need treatment for their acute mental health crisis. Ocean View Psychiatric Health Facility’s professional team of medical, mental health, and crisis services providers ensures that each individual receives tailored care to meet their needs.

What Common Phrases Reflect Refusal or Mistrust?

Phrases that are commonly used to show mistrust or refusal to treatment include “I don’t trust your advice” or “I don’t think this will help me.”

Other phrases often used are:

• “I haven’t heard good things about this treatment.”
• “I prefer a natural treatment.”
• “Let me think about it.”
• “It’s too expensive.”

These phrases reflect skepticism, lack of confidence in the mental health provider, hesitation, financial concerns, and an interest in natural ways to treat their mental health disorder. By engaging your loved one with the communication tools in LEAP, you can build trust while letting them know they are loved and respected.

How Can I Tell Refusal From Temporary Ambivalence?

Temporary ambivalence occurs when an individual has conflicting thoughts or feelings about an event or situation, leading to indecision. In contrast, refusal is a choice to reject or avoid a situation.

When an individual refuses to acknowledge a situation, they have chosen to disengage from it. Conversely, temporary ambivalence occurs when they feel torn between choices and can’t decide. Another difference between the two is choosing not to engage, rather than feeling uncertain and conflicted about what to do.

Communicating Using LEAP Principles

How Should I Open a Conversation About Mental Health?

Starting a conversation about mental health can be challenging, but if you choose a place and time when you and a loved one feel comfortable, you can feel less uncomfortable about the conversation.

When the conversation begins, how you talk and the words chosen make a difference. Empathy is critical when discussing concerns, and it is also vital to allow your loved one to share their feelings when they are ready.

What Empathy and Listening Techniques Does LEAP Recommend?

When speaking with a friend or family member, LEAP recommends expressing your concern by remaining fully engaged, avoiding interruptions, and validating their emotions and experiences.

These techniques help build healthy relationships by focusing on understanding, encouraging individuals to share their feelings openly, and reducing or preventing tensions that can lead to problems.

How Do I Set Boundaries Without Increasing Stress?

Successful boundary setting includes self-awareness, strong communication skills, and maintaining a tone of voice that is assertive yet not argumentative.

Setting boundaries can reduce stress by protecting your emotional well-being. When you start defining your boundaries, use “I” statements to express your needs or feelings without being confrontational.

Practical Conversation Tools

What Are Example Opening Lines to Invite Dialogue?

Phrases to open a conversation can include:

• “I’m here to listen if you want to talk about anything.”
• “How have you been feeling lately?”
• “I’ve noticed you seem a bit sad lately, and I thought I would check in.”

What Follow-up Questions Keep Conversations Constructive?

Follow-up questions let the person speaking know you’re interested in what they’re saying. Some of the effective questions are:

• “I can tell you have strong feelings about this, and I respect that. Will you help me understand more?”
• “How did you make that conclusion?”
• “Can you explain this to me a bit further?”

How Should I Respond if the Conversation Becomes Defensive?

If a conversation becomes defensive, use “I” statements to explain how you feel and keep your voice calm and steady.

When you use “I” statements, the other person won’t feel like they’re being blamed for the situation, their thoughts, or their feelings. Additionally, maintaining a calm tone of voice can help prevent the conversation from escalating.

Finding Professional Support

How Can I Find a Health Care Provider or Treatment?

There are several ways to find a mental health provider, including online tools like social media.

Internet search sites are also effective in helping you find a mental health provider because they can provide a focused search on your needs and location.

Should I Seek Early Intervention?

Yes, early intervention is helpful because early treatment can reduce or prevent symptoms of mental health disorders like bipolar disorder or schizophrenia.

What Questions Should I Ask When Contacting a Provider?

Knowing what questions to ask when contacting a provider is important. Examples of questions you should ask are:

• What is your education and training?
• What kind of license do you have?
• What is your degree in?
• How long will therapy last?
• How long are sessions, and how often do I need to see you?
• Will medication be an option?
• Do you accept health insurance?

How Can I Help Arrange Evaluations or Appointments?

When you help arrange appointments or evaluations, you can clearly communicate the reason for one or the other and ask your loved one for the vital information you need to schedule.

Supporting Treatment & Recovery

How Can I Support Medication and Therapy Needs?

Supporting your loved one’s therapy and medication needs includes regularly talking with their healthcare provider to monitor and adjust medication or therapy as needed.

What Daily Routines or Environmental Changes Support Recovery?

Creating healthy, stable daily routines and environmental changes to support recovery include regular:

• Exercise 
• Sleep 
• Nutritious food
• A calming environment
• Organized spaces

When Should I Encourage Peer Support or Family Groups?

Encouraging a loved one to engage in family or support groups can occur during conversations focused on mental health wellness. 

The techniques in LEAP allow you to discuss the possibility of including family and peer support groups without making your loved one feel pressured. Together, you can explore the possibility and guide them to seek these forms of care.