Book excerpt: This book offers a practitioner's guide to evidence-based practice in working with psychotic patients in an outpatient setting by clinicians and scholars who are internationally recognized for their work in treating severe psychopathology. Topics cover conceptual, technical, and practical considerations in the parameters of working with adult and adolescent populations that exhibit thought disorder, delusions, hallucinations, borderline organizations, trauma, and schizoid phenomena. Different theoretical models are presented from psychoanalytic traditions that introduce the student and practitioner to eclectic ways of conceptualizing and treating these challenging clinical groups. Concrete approaches to establishing a proper treatment environment, working alliance, symptom management, managing countertransference, and facilitating a therapeutic framework are provided. Various psychodynamic techniques are demonstrated by master clinicians through the extensive use of clinical case material culled from outpatient settings that illustrate how psychoanalytic perspectives enrich our understanding of the psychotic spectrum and lead to therapeutic efficacy.