Comprehensive exams for Mental Health Q 134
A client with paranoid schizophrenia has been experiencing auditory hallucinations for many years. One approach that has proven to be effective for hallucinating clients is to:
A. Take an as-needed dose of psychotropic medication whenever they hear voices.
B. Practice saying “Go away” or “Stop” when they hear voices.
C. Sing loudly to drown out the voices and provide a distraction.
D. Go to their room until the voices go away.
Correct Answer: B. Practice saying “Go away” or “Stop” when they hear voices.
Researchers have found that some clients can learn to control bothersome hallucinations by telling the voices to go away or stop. The estimated prevalence of auditory hallucinations in the general population ranges from 5 to 28%. Auditory hallucinations are the most commonly reported in psychotic patients. They are prevalent in 75% of individuals suffering from schizophrenia, 20-50% of individuals with bipolar disorder, 10% of individuals with major psychotic depression, and 40% of individuals with PTSD.
Option A: Taking an as-needed dose of psychotropic medication whenever the voices arise may lead to overmedication and put the client at risk for adverse effects. Because the voices aren’t likely to go away permanently, the client must learn to deal with the hallucinations without relying on drugs.
Option C: Although distraction is helpful, singing loudly may upset other clients and would be socially unacceptable after the client is discharged. In children and adolescents, the prevalence has been noted to be 9% and ranging between 5 to 16%, respectively. In children, it is mostly seen in conjunction with conduct disorder, migraine, and anxiety. The discontinuation rate of auditory hallucinations in adolescence ranges from 3 to 40% each year.
Option D: Hallucinations are most bothersome in a quiet environment when the client is alone, so sending the client to his room would increase, rather than decrease, the hallucinations. Auditory hallucinatory experiences are psychopathological end-points. Disturbances in consciousness may occur earlier in the course that includes thought blocking, thought pressure, obsessive perseveration, and failure to discriminate between thought and perception.