Some paranoid disorders such as paranoid personality disorder and paranoid schizophrenia may have more bizarre behavior and have intense feelings of distrust or fear. These clients will not confide in others and may be difficult to talk to as they often misinterpret harmless conversation or behavior.
Criteria and symptoms must persist for one month or more, and cannot be attributed to substance use or another medical or mental condition.
Client will be able to identify appropriate coping techniques. Client remains safe and free from harm.
To determine if there are other issues that may be causing symptoms or if disorder has progressed to another serious conditions such as schizophrenia
Determine how client interacts with others. Paranoid clients may exhibit aggressive behaviors for no apparent reason.
Help build trust and rapport with clients. Paranoid clients may be more reluctant to trust anyone, but open communication generally offers more cooperation
Prevents aggressive behavior and suspicion. Promotes cooperation and compliance. Helps develop trust.
Avoid startling the client, sudden movements or touching the client unnecessarily
Even the best of intentions, such as a handshake, tidying the room, or body language may be misinterpreted as threatening and may lead to aggressive behavior.
Showing respect for client’s space and possessions helps build trust.
Helping clients see the reality of their own behaviors can help treatment progress and lead to more appropriate behaviors and interactions.
Helps client develop more positive coping skills for dealing with delusions, suspicions and fears
Overstimulation from loud noises, excessive talking, television or radio may increase paranoia and prompt erratic or aggressive behaviors.
Help client develop relationships and more positive interactions with others. Helps reorient client to reality. Forcing them to participate may trigger paranoia that you are trying to trick or trap them.
Promote the safety of client during agitated moments and the safety of others from aggressive behaviors.
Follow your facility’s specific protocol regarding supervision, restraint, and documentation.
Antipsychotic medications may be given to manage delusions and behaviors. Monitor for adverse reactions.
Promote a sense of self-worth and improves self-esteem
Depending on their culture, some behaviors and beliefs may be considered acceptable to the client. Take these into consideration when implementing interventions.
Client may need to be refocused to reality at times, but avoid confrontation that may be interpreted as argumentative to avoid noncompliance and uncooperative behaviors.
Help family members understand the nature of the client’s illness and avoid conflict that could exacerbate the client’s symptoms.
Encourages coping skills of family members through each other and support groups.
Help develop trust between client and loved ones, and promotes positive management of illness going forward. Help client and family members stay on track with treatment.
For more information, visit www.nrsng.com/cornell
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