Question

A client with a persecutory delusion has been explaining to the nurse the specifics of the conspiracy against the client. The client pauses and says, "I get the feeling that you don't actually believe that what I'm telling you is true." How should the nurse respond?

-"What you're telling me is difficult for me to believe. This may be real for you, but not me."
-"What's important to me is that it's real for you."
-"The conspiracy that you're explaining to me is actually a delusion."
-"What makes you think that I don't believe you?"

Answer 1

For a client with persecutory delusions, the nurse should respond with empathy, saying, "What's important to me is that it's real for you," to acknowledge the client's experience without reinforcing the delusion. The approach maintains trust and supports the client.

Step-by-step explanation:

When a client with a persecutory delusion expresses doubt about whether the nurse believes in their conspiracy, a professional and therapeutic response is critical. The best approach would be to validate the client's feelings without reinforcing the delusion. The nurse could respond with empathy and focus on the client's experience by saying, "What's important to me is that it's real for you." This response acknowledges the client's reality without confirming the delusion as truth, aiming to maintain a trusting relationship and providing comfort.

Dealing with a client's alternative explanations for their perceptions can be challenging. The nurse should aim to engage the client without dismissing their experiences outright, as this can damage the therapeutic relationship. Similarly, presenting scientific or alternative views must be done with care to avoid creating more confusion or resistance from the client. The goal is always to foster an environment where the client feels heard and supported while receiving appropriate care and treatment.