Schizophrenia Q 21
A client tells the nurse that people from Mars are going to invade the earth. Which response by the nurse would be most therapeutic?
A. “That must be frightening to you. Can you tell me how you feel about it?”
B. “There are no people living on Mars.”
C. “What do you mean when you say they’re going to invade the earth?”
D. “I know you believe the earth is going to be invaded, but I don’t believe that.”
Correct Answer: A. “That must be frightening to you. Can you tell me how you feel about it?”
This response addresses the client’s underlying fears without feeding the delusion. 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 B: Refuting the client’s delusion would increase anxiety and 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 C: Asking the client to elaborate on the delusion would also reinforce it. 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.
Option D: Voicing disbelief about the delusion wouldn’t help the client deal with underlying fears. Show empathy regarding the client’s feelings; reassure the client of your presence and acceptance. The client’s delusion can be distressing. Empathy conveys your caring, interest, and acceptance of the client.