not too hard really. the topic of discussion goes where the patient takes you. if attempting to uncover a rationale for why a patient says or does a particular behavior, simply ask. for example, "i notice when a paticular tv show comes on, you do x, y, and z. how come?"...pretty simple. keep it objective, respectful, genuine, and realistically honest. sometimes, offering a little benign self disclosure can open the door too. "you know, when i watch that tv show, i usually just fall asleep, become a little irritated too, etc, etc"...take your pick. most folks with schizophrenia, if not extremely paranoid, will share and discuss their symptoms and what triggers them. sometimes, i'll bring up a past observation...if similar and relevent...and compare it to the current situation/observation with the patient. then, i invite the patient to discuss the similarities and differences (to explore symptom triggers) between the two events. another way is to convey empathy (this is not pity) and to enlist your therapeutic use of self by simply stating that "it must be difficult at times dealing with x symptom. how do you do it or cope with this? how can i help prevent the symptom getting worse for you?"...is another way to invite a discussion. another way is to invite the patient to instruct you how schizophrenia impacts a person's daily life. admit your ignorance and need to learn. a very honest statement. the patient may very well respect you for it. you have no better instructor than the patient him/herself. he/she deals with it on a daily basis. the key thing is honesty. when you are not honest, folks with schizophrenia can pick up on this readily, especially if paranoid. so, another part to this is that your body language and facial expressions need to match what you say or convey. lastly, many folks with this disorder have been therapized,analyzed and juvenilized to death in the course of their illness. being respectful also means being sensitive to this. there is nothing worse than to "talk down" to a person with schizophrenia. treat and respect the person as an individual, as an adult, and worthy of your time. use everyday words, not "ten dollar ones" to impress. remember, they probably have seen alot of professionals and students in their lives and probably have seen it all and seen all types...good and not so good. if you haven't guessed, folks with schizophrenia were my most enjoyable patients. they live through so much.
it's all in the approach.
oh, one last point, medication is crucial with this disorder. non-compliance is a big issue as well...a major factor for relapse. learning about the medications used with this disorder is vital in your training.
i wish you the best.
i hoped this helped some.