How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 36

This book is in B&W, not color - Print page in Grayscale for Correct view! • Talking with someone who mentions their delusional beliefs:    Show some understanding of the person’s feelings, eg ‘It must be really scary to think that someone else is controlling your thoughts’. Do not argue about the strange ideas but do not pretend to agree with them either. Focus instead on how the delusions make them feel and then change the subject to something neutral or pleasant in real life (eg what is for dinner?). If the conversation is distressing to the patient or to you, it is OK to say, ‘I’ll talk to you later when you’re feeling a bit better’. • Relating to someone who is withdrawn or isolated:     Be prepared to sit with the patient in silence. Doing practical tasks close to the patient can be comforting. Sharing activities without talking can also be helpful. Gently encourage other activities which are not too demanding (eg watching television, washing dishes, playing a board game). Be prepared to keep trying. It can take a long time for some people to respond. • Talking with someone who is angry or aggressive. People with schizophrenia are usually shy and withdrawn. However, they may also become aggressive, especially when they are experiencing fear or paranoia (feeling that they are being persecuted and that other people are out to get them) or voices (voices can, rarely, command a person to injure others). To reduce patient fears and the potential for aggression, it may be helpful to do the following: — Give the patient space. Do not crowd them. — Inform the patient about what you are doing and intend to do. — Tell the patient that you do not mean them any harm. — Talk calmly and evenly. — Talk to the patient in a quiet environment. — Continually reassure them. — Keep your hands in view. — Keep your movements to a minimum. — Ask them why they are upset. 2. Observation: contribution to assessment Nurses and healthcare officers may spend long periods with patients. Your observations of the patient’s behaviour are a very valuable part of the assessment. General information about conducting observations is provided in Observation. In psychotic illness, helpful observations include the frequency, intensity and duration of ‘positive symptoms’ and the extent of ‘negative symptoms’. Positive symptoms include: Negative symptoms include: • • • • • • • • • Hallucinations. Delusions. Thought disorder. Paranoia. Lack of motivation. Social withdrawal. Emotional withdrawal. Difficulty in forming relationships. Lack of spontaneity. For [email protected] Property of Bookemon, do NOT distribute 38