Question: How would you build a therapeutic alliance with Hayden to address the connection between physical symptoms and mood disorder? answer- To build a therapeutic alliance, offer Hayden a way to see his situation in a new, non-blaming manner. This can be done by recognizing Hayden's physical symptoms as real and connecting them to his anger at physicians and family who do not believe in his suffering. When Hayden trusts you, it allows Hayden and you the ability to agree that he indeed experiences real symptoms that provoke pain and anxiety. Do not accuse Hayden of lying. Be wary of countertransference. When a provider countertransfers their feelings of frustration onto a patient, it results in division between the patient and provider. Seek clarification from Hayden rather than confrontation. Consider possible security measures because malingers can respond by escalating their behavior in an attempt to justify their physical illness. In extreme cases, malingerers might have physical aggression or self-injury in front of you. Provide a safe environment by providing feedback that is informative and not judgmental. Feedback must be constructive and promote understanding, such as acknowledging Hayden's situation and focusing on his strengths as therapy continues. Doing so promotes trust and allows Hayden to correlate his self-harm to factitious disorder or secondary gain. Ask questions that allow him to gain insight, which will strengthen the therapeutic alliance. Need Assignment Help?