The Jesalva Algorithm: Principle #1-The Patient Has to Want to Change

This is probably makes up 50% of the treatment process.  The patient has to WANT to change for the better.  Change takes time, effort, commitment and patience.  These attributes will be tested during the sometimes long and arduous process of treatment. 
I always refer my patients to a good psychotherapist to help with this process.  A good therapist will be able to help with non-medications issues related to the patients psychological functioning.  There might be issues that get in the way especially with relationships with others and themselves.  Some common issues deal with accepting the illness, accepting treatment with medications, control issues, maladaptive behaviors, to name a few.