To successfully treat those with severer mental health disorders, the therapist must take little for granted, ignoring accepted beliefs about prognosis and motivation since clinician prejudice can arouse unjustified feelings of defeatism and hopelessness.
Each person is unique with another being unable to know their experience fully and the depth of their suffering. The sicker patient knows much about themself but, from guilt or fear of acting-out impulsively, is afraid to allow themselves to feel what they know. Nor because of their low self-esteem do they value this knowledge. So they retreat from what is most useful: to feel what they know.
Thus when a patient refers to the presumed hopelessness of the diagnoses they had formerly been told, they should be reminded that they are a complex human being and not a simple diagnostic classification.