Recent advances in the pharmacological treatment of Alzheimer's Disease has meant that the cognitive decline for patients in the early stages of the disorder can be delayed. The improved prognosis means that patients may have considerable insight into their illness for a much longer period, which may be emotionally distressing for themselves and their families. This paper describes the development of a brief psychological intervention, based upon psychodynamic-interpersonal therapy, for patients in the early stages of Alzheimer's Disease. The key components of the model include: picking up cues; staying with feelings; working in the ‘here and now’; negotiation; understanding, linking and explanatory hypotheses; metaphor; sequencing of interventions (i.e. picking up cues → staying with feelings → linking to interpersonal problems); and the development of a shared interpersonal formulation. The cases discussed in this paper are drawn from a pilot study of psychodynamic interpersonal therapy plus usual care versus usual care alone.