Schizophrenia Q 12
Gio told his nurse that the FBI is monitoring and recording his every movement and that microphones have been placed in the unit walls. Which action would be the most therapeutic response?
A. Confront the delusional material directly by telling Gio that this simply is not so.
B. Tell Gio that this must seem frightening to him but that you believe he is safe here.
C. Tell Gio to wait and talk about these beliefs in his one-on-one counseling sessions.
D. Isolate Gio when he begins to talk about these beliefs.
Correct Answer: B. Tell Gio that this must seem frightening to him but that you believe he is safe here.
The nurse must realize that these perceptions are very real to the client. Acknowledging the client’s feelings provides support; explaining how the nurse sees the situation in a different way provides reality orientation. Recognize the client’s delusions as the client’s perception of the environment. Recognizing the client’s perception can help you understand the feelings he or she is experiencing.
Option A: Confronting the delusional material directly will not work with this client and may diminish trust. Attempt to understand the significance of these beliefs to the client at the time of their presentation. Important clues to underlying fears and issues can be found in the client’s seemingly illogical fantasies.
Option C: Telling the client to wait and talk about these beliefs in his one-on-one counseling session will reinforce the delusion. Initially do not argue with the client’s beliefs or try to convince the client that the delusions are false and unreal. Arguing will only increase a client’s defensive position, thereby reinforcing false beliefs. This will result in the client feeling even more isolated and misunderstood.
Option D: Isolation will increase anxiety. Distraction with a radio or activities would be a better approach. Interact with clients on the basis of things in the environment. Try to distract the client from their delusions by engaging in reality-based activities (e.g., card games, simple arts and crafts projects, etc). When thinking is focused on reality-based activities, the client is free of delusional thinking during that time. Helps focus attention externally.