Final answer:
Clients may seem out of touch with reality in the denial stage of Elisabeth Kübler-Ross's five stages of grief, which also include anger, bargaining, depression, and acceptance.
Step-by-step explanation:
Clients may seem out of touch with reality in the denial stage of the grief process. Elisabeth Kübler-Ross's model describes denial as the first reaction to the prospect of dying, where the person may not accept the reality of their situation, characterized by thoughts such as "I feel fine" or "This can't be happening to me." This stage is part of the five stages of grief, which include denial, anger, bargaining, depression, and acceptance, as discussed in her 1969 book On Death and Dying.