Parents ask the P.T. what to say when the paranoid schizophrenic son reports hearing voices. The best response is?

Parents ask the P.T. what to say when the paranoid schizophrenic son reports hearing voices. The best response is?

• A. Tell him to stop discussing the voices or else you will conclude the visit.
• B. Ignore what he is saying and attempt to talk over him.
• C. Neither confirm nor deny the content but try to focus on reality.
• D. Tell him that the voices are not real and that he is going to have to stop talking about them.

Answer: (C)

When someone with schizophrenia reports hearing voices, respond with empathy and grounding rather than arguing about reality. The best approach is to acknowledge the experience without confirming or denying the content, and gently guide the conversation toward safety and coping in the present moment. This maintains trust and avoids escalating paranoia, while opening the door to useful actions the patient can take. So, recognize that the voices are distressing for the patient, and shift the focus to grounding in reality and coping strategies. For example, you can validate the distress and then ask about what helps him stay safe, calm, or focused right now. If the voices raise safety concerns or command behavior, assess and address those risks within the treatment plan. Why the other approaches don’t fit: telling him to stop discussing them or talking over him dismisses his experience and can undermine trust; ignoring what he says leaves him unsupported; insisting that the voices aren’t real challenges his reality and can worsen paranoia and noncompliance.

When someone with schizophrenia reports hearing voices, respond with empathy and grounding rather than arguing about reality. The best approach is to acknowledge the experience without confirming or denying the content, and gently guide the conversation toward safety and coping in the present moment. This maintains trust and avoids escalating paranoia, while opening the door to useful actions the patient can take.

So, recognize that the voices are distressing for the patient, and shift the focus to grounding in reality and coping strategies. For example, you can validate the distress and then ask about what helps him stay safe, calm, or focused right now. If the voices raise safety concerns or command behavior, assess and address those risks within the treatment plan.

Why the other approaches don’t fit: telling him to stop discussing them or talking over him dismisses his experience and can undermine trust; ignoring what he says leaves him unsupported; insisting that the voices aren’t real challenges his reality and can worsen paranoia and noncompliance.