Schizophrenia Q 45
Drogo, who has had auditory hallucinations for many years, tells Nurse Khally that the voices prevent his participation in a social skills training program at the community health center. Which intervention is most appropriate?
A. Let Drogo analyze the content of the voices.
B. Advise Drogo to participate in the program when the voices cease.
C. Advise Drogo to take his medications as prescribed.
D. Teach Drogo to use thought-stopping techniques.
Correct Answer: D. Teach Drogo to use thought-stopping techniques.
Clients with long-lasting auditory hallucinations can learn to use thought-stopping measures to accomplish tasks. In this technique, when the obsessive or racing thoughts begin, the client says, clearly and distinctly, “Stop!” This then allows the client to substitute a new, healthier thought. Many therapists encourage the client to, at first, yell out the “Stop!” This helps focus the attention on the word and away from the obsessive thought. Later, the client will be able to mentally yell the word to themselves without needing to say it aloud.
Option A: Analyzing the content of the voices may be indicated when hallucinations first occur to establish whether the voices are threatening to the client or instructing him to harm others. However, focusing on their content at this point would reinforce this symptom. Keep to simple, basic, reality-based topics of conversation. Help the client focus on one idea at a time. Client’ thinking might be confused and disorganized; this intervention helps the client focus and comprehend reality-based issues.
Option B: The voices have lasted many years; the client should participate despite the voices. Work with the client to find which activities help reduce anxiety and distract the client from hallucinatory material. Practice new skills with the client. If clients’ stress triggers hallucinatory activity, they might be more motivated to find ways to remove themselves from a stressful environment or try distraction techniques.
Option D: There is no indication that the client is not taking medication as prescribed. Stay with clients when they are starting to hallucinate, and direct them to tell the “voices they hear” to go away. Repeat often in a matter-of-fact manner. The client can sometimes learn to push voices aside when given repeated instructions. especially within the framework of a trusting relationship. Intervene with one-on-one, seclusion, or PRN medication (As ordered) when appropriate.