Question by Eyes have not seen…: Mental Health?
As a Social Worker, I am looking for better ways to engage clients with severe mental health dx’s (schiophrenia, bi-polar, paranoia, etc.) to get them interested or involeved in their care. Any suggestions of approaches? Also what do u find helpful when trying o speak to a client wxperiencing delusions/hallucinations?
Best answer:
Answer by Brad W
when speaking to them during a hallucination… keep asking them what they are seeing ask them to describe what is going on and calmly talk to them slipping in a couple questions you really want to know the answer to
What do you think? Answer below!
I have experienced working with people like you described in the legal field and they don’t like anything that would worry them because they will panic. I also like to not upset them too much about their delusions because they get really upset when they don’t think people believe them. I just listen and act like I really care. That’s all they really want. And I have found that many of these people trusted me because they thought I genuinely cared.
Say that everything is all right. Be patient and firm, lie if you have to. Try to search into what seems to bring them joy or remind them of something enjoyable, also comfort them. Yet I believed that the mental problems you mentioned are all really different in nature. Different approaches work with different kinds. For example, those who are paranoid, I beleive, are very hard to control. So try somethings out, and if some approaches work better than others, continue them.
Dr. John Breeding has some insight into it..
http://www.youtube.com/watch?v=adhM2mUO2Mw
You need to gain their trust. They won’t share a thing with you without that trust. When they speak repeat to let then know that you heard them. Say things to reassure them that you care because if they don’t think you care they will not trust you. Trust is very important to your clients. Know that you will not be able to make that connection with every client.
Use any creative approach. I know sand trays are fascinating for the population you mentioned. Also journaling is another way they can express themselves. Give them a set of color pencils. Or a disposable camera.
I worked as a trainer for Goodwill mainly with what your working with now. You have to have a good professional relationship with the client, And when they are delusional/ hallucinating I just asked them , how they were doing and I would steer them to the office that way they could be safe and they were where it was quiet.,and talk to them. what going on?, what do you see /, and let then get settled enough that they were more stable , ask when they took their meds last etc. do you need your doctor, and they would get more settled. half the time the guys were off their meds from Friday to Monday morning.if they had girlfriends. They usually would go back to work and they would find me if they had to go home. You get to recognise the problem ones that you have to watch I had an easy going style that let them not worry too much. They worried about losing work time having to see the dr. Just be calm and they feel safe.
Have you tried Linehan’s “Skills Training for Borderline Personality Disorder” workbook? I used exercises from this during graduate training in an outpatient mental health clinic.
A couple of years ago, I was at a conference on community mental health that talked about client/consumer-based programs that were pretty much primarily run by the clients themselves. I don’t know the severity level of your population, but I would try to get the clients to support each other as best I could, and research client- or consumer-based programs and their efficacy levels. I thinking that that clients will respond to encouragement from their peers more than they will respond to encouragement from their therapists.
In regards to delusions and hallucinations, based on my experience, the best way to intervene is to 1) enter their reality and never invalidate it 2) empathize with the feeling
3) based on their past history, try to interpret accordingly and 4) if you confront them, confront them on the effects of their thinking – not that their thinking is wrong – e.g. how is their thinking making their life better or worse, and is there a better, safer, more workable alternative?
Good luck.
When I just pray about it and fast and ask the Lord to Guide you into the right path to help heal those whom can’t heal themselves and to help their hearts and minds.I’ll be praying for you. I hope this helps.