Active engagement in the consultation process1 <FN ID="FN1"><NO>1</NO>Note: The concepts described in this paper are illustrated in two edited videotapes, A Brief Therapy in the Context of Loss and Psychological Engagement of the Physically Ill and Dying Patient, to be distributed by the American Psychiatric Press.</FN>

This paper presents a case for the active, dynamic engagement of patients during consultations. Observations and hypotheses about the patient’s predominant conflicts are used to formulate interventions early in the consultation process that are designed to convey meanings that make the patient’s experience comprehensible to him. This includes attention to his personality and his world view. The activity of the consultant in appropriately communicating aspects of these formulations to the patient is designed to facilitate the process of self-revelation and to permit a co-construction with the patient of a perspective on aspects of his life experience and his current problems. Active, dynamic engagement leads to the development of a bond between consultant and patient that facilitates the implementation of a treatment plan. Numerous case descriptions are included to illustrate this active approach as applied in different contexts. [Copyright &y& Elsevier]