Background: Psychiatric staff play a key role in the lives of people with psychosis and the quality of staff and service user relationships is associated with relapse and recovery. One factor that might determine the capacity of staff to form positive therapeutic relationships is their appraisals of service users' mental health problems. Method: A pilot intervention was implemented with psychiatric staff that involved helping them develop psychological formulations for individual service users. Staff perceptions of service users' mental health problems were measured before and after the intervention using Likert scales. Data at the two time points were collated for 30 staff. Results: There was a significant increase in staff perceptions of the degree of control service users and themselves had over problems, an increase in the degree of effort they felt service users were making in coping, reductions in blame, and more optimism about treatment. Staff also reported an increase in understanding of service users' problems, more positive feelings towards service users, and an increase in confidence in their work. Conclusions: Results from this pilot are promising, but findings warrant replication in controlled studies. It is also important to establish whether changes in staff perceptions influence the actual nature of staff-service user relationships.