Abstract: The purpose of this study was to conduct an in-depth analysis of Direct Confrontation Psychotherapy in an attempt to describe the methods associated with this approach. The investigation involved a microanalysis of verbal, paralanguage, and nonverbal processes occurring between patient and therapist during four treatment sessions. By completing a microanalysis using the three modes of communication it was possible to observe treatment sessions in such a way that they could be described in conjunction with the theoretical framework. The question on which this study was based is: What is Direct Confrontational Psychotherapy with schizophrenics, and how is it done? In order to address this question the study analyzed the communicative behavioral patterns between patient and therapist during the course of psychotherapy. Four psychotherapy sessions were videotaped of a chronic schizophrenic and direct confrontation psychotherapist (Jack Rosberg, founder of this approach) beginning with the first therapy session, followed by sessions 1 month, 1 year, and 2 years later. The communication patterns during the four stages of psychotherapy between patient and psychotherapist were analyzed by two independent observers. Since only three of the four stages were present in the single case study, three additional videotaped segments of other patients were analyzed. The verbal content was analyzed using Neurolinguistic Programming's method of identifying complete or incomplete sentence structure, using the general mechanisms of generalization, deletion, and distortion. The paralanguage was analyzed by breaking down the intonation, determined by pitch; the rate, determined by stress and phrasing; and loudness, determined by the level of intensity and the use of vocal dynamics. The nonverbal communications were analyzed using Delsarte's system of movement expression. Observations of the head, torso, and limbs were recorded; these included gestures and facial expressions. A synthesis was then made in conjunction with theoretical formulations of Direct Confrontational Psychotherapy as they applied to the four sessions. The results indicated interpersonal communicative changes in the schizophrenic patient over the 2-year period, while the therapist remained consistent. Changes in the schizophrenic patient's verbal content revealed a more varied use of complete sentences, more dynamic use of paralanguage, and a more integrated use of nonverbal movement expressions. The methods used by the psychotherapist was described in relation to the theory of Direct Confrontation Psychotherapy. This study was the first complete theoretical and descriptive representation of Direct Confrontation Psychotherapy.