Considering the relative elevation of this scale can be extremely important because it provides an index of the degree to which clients can develop a trusting relationship, their attitudes toward authority figures, and their degree of flexibility. Very high scores suggest psychotic processes possibly requiring medication (check BIZ/Bizarre Mentation and critical item clusters related to manual confusion and persecutory ideas subscales). Psychotherapy with individuals scoring high on Scale 6 would be extremely difficult because of their rigidity, poor level of insight, and suspiciousness (check. TRT/Negative Treatment Indicators Content scale). In addition, they do not like to discuss emotional issues, overvalue rationality, and are likely to blame others for their difficulties. They frequently will not return following the initial session and leave feeling that they have not been understood. Thus, a major challenge with an intake is to make sure that they feel understood. During subsequent sessions, they might attempt to manipulate the therapist by implicitly suggesting they will terminate. They are often argumentative, cynical, and resentful, thereby making it difficult to establish a relationship of mutual trust, empathy, and respect. If brooding and resentment are particularly pronounced, it might be important to assess for potential dangerousness toward others.