Schizophrenia Key interventions

Why may someone with schizophrenia Self Isolate?

Preoccupation with own thoughts

Inability to TRUST

Panic anxiety

Weak ego

Regression

Disturbed thought process r/t Delusion thinking

Can’t Concentrate

Inability to problem-solve and think abstract

Suspicious

Someone with schizophrenia may have trouble…

Caring for self (hygiene), health, and home (tertiary prevention!)

What are nursing interventions for schizophrenia geared toward?

establishing TRUST

Suspiciousness is common!

Interventions for auditory/visual hallucinations

Assess for signs of hallucinations (don’t say hallucination)

Assess risk of command

Avoid touch without warning

Use “the voices”

“Even though I realize the voices are real to you, I do not hear any voices”

Distract with HEADPHONES, music, radio, TV

Voice Dismissal - “Go Away!”

How to therapeutically assess for signs of Hallucinations

“are you hearing something else?”
“Are you hearing other voices”

Assess content of command hallucinations

“what do you hear the voices saying to you?”

Interventions for disturbed thought process

Don’t argue/DENY belief

• Reasonable doubt

Reinforce and focus on reality

Interventions for a highly suspicious patient

Same staff

Honest, keep promise

Avoid Touch

Avoid laughing, whispering, or talking quietly where the pt can see but not hear

Provide caned food/family style

Mouth checks for meds

How to use reasonable doubt as a therapeutic technique

“I understand that you believe this is true, but i personally find it hard to accept”

Nursing Interventions for Social Isolation

Unconditional positive regard

Offer to be with pt during group

Interventions for impaired verbal communication

Seek clarification and validation

• “Is it that you mean…?” “I don’t understand what you mean by that”

Consistent staff assignments

Verbalizing the implied

orient to reality

Call pt by name

Simple clear instructions - “pick up the spoon, scoop mashed potatoes”

Verbalizing the implied

WHEN STRUGGLING TO COMMUNICATE

“That must be frightening to worry that others are wiretapping your house”