A paranoid schizophrenic reports voices seeming to come from the radio and telling him what to do. What is the best intervention?

A paranoid schizophrenic reports voices seeming to come from the radio and telling him what to do. What is the best intervention?

• A. Ignore the hallucinations and reorient to reality.
• B. Ask the client 'What are the voices telling you to do?'
• C. Inform him that he is having an auditory hallucination and change the subject.
• D. Let the client know that you believe he is hearing voices but you don't hear them.

Answer: (B)

When someone is experiencing auditory hallucinations, the best approach is to respond with empathy and curiosity, inviting the person to share more about what they’re hearing. Asking what the voices are telling him to do opens a safe path for communication, which is crucial for safety and trust. It validates the experience without arguing about its reality, and it gives you concrete information about any commands that could put him or others at risk. This open-ended question helps you assess danger: if the voices are directing him to harm himself or someone else, you can plan immediate safety steps and involve the team as needed. It also helps you gauge how distressing the experience is and whether grounding or coping strategies should be introduced. By focusing on the content and the impact of the voices, you gather essential data while maintaining rapport and reducing the likelihood of escalation. Other approaches that dismiss or challenge the hallucination can damage trust and miss the chance to assess risk or provide needed support. For example, telling him the voices aren’t real or changing the subject can feel invalidating; claiming you believe him but you don’t hear them distances you from his experience and doesn’t help with safety planning. So, asking what the voices are telling him to do is the most effective step because it respects his experience, reveals critical safety information, and guides your next interventions.

When someone is experiencing auditory hallucinations, the best approach is to respond with empathy and curiosity, inviting the person to share more about what they’re hearing. Asking what the voices are telling him to do opens a safe path for communication, which is crucial for safety and trust. It validates the experience without arguing about its reality, and it gives you concrete information about any commands that could put him or others at risk.

This open-ended question helps you assess danger: if the voices are directing him to harm himself or someone else, you can plan immediate safety steps and involve the team as needed. It also helps you gauge how distressing the experience is and whether grounding or coping strategies should be introduced. By focusing on the content and the impact of the voices, you gather essential data while maintaining rapport and reducing the likelihood of escalation.

Other approaches that dismiss or challenge the hallucination can damage trust and miss the chance to assess risk or provide needed support. For example, telling him the voices aren’t real or changing the subject can feel invalidating; claiming you believe him but you don’t hear them distances you from his experience and doesn’t help with safety planning.

So, asking what the voices are telling him to do is the most effective step because it respects his experience, reveals critical safety information, and guides your next interventions.