A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his
sales. Today, he argued with several office mates and threatened to kill one of them.
The police were
called, and he was brought to the mental health center for evaluation. He has had previous
admissions to the unit for stabilization of symptoms of paranoid schizophrenia. When the nurse
meets him, he points at staff in the nursing station and states loudly "They're all plotting to destroy
me. Isn't that true?" An appropriate response for the nurse would be
a. "No, that is not true. People here are trying to help you if you will let them.".
b. "Everyone here is trying to help you. No one wants to harm you.".
c. "Thinking that people want to destroy you must be very frightening.".
d. "That is absurd. Staff are health care workers, not members of the mob.".
C
Resist focusing on content; instead, focus on the feelings the client is expressing. This strategy
prevents arguing about the reality of delusional beliefs. Such arguments increase client anxiety and
the tenacity with which the client holds to the delusion. The other options focus on content and
provide opportunity for argument.
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