Which option best demonstrates an appropriate way to respond to a patient with paranoid delusions who asks whether the voices are real?

Which option best demonstrates an appropriate way to respond to a patient with paranoid delusions who asks whether the voices are real?

• A. That's not real
• B. Can you tell me what the voices are saying?
• C. Ignore the voices
• D. You must stop talking about them

Answer: (B)

When supporting a patient with paranoid delusions and voices, the goal is to validate the experience and stay engaged rather than argue about what’s real. The best response is to invite the patient to describe the voices and what they are saying. This open-ended question shows you are listening, lowers defensiveness, and helps you gather important information about the content, level of distress, and any safety concerns. It also helps you assess whether the voices are commanding or otherwise risky, so you can plan appropriate care. Saying the voices aren’t real dismisses the patient’s experience and can damage trust. Ignoring the voices or telling the patient to stop talking about them leaves distress unaddressed and can increase agitation or risk. By asking what the voices are saying, you create a safe space for the patient to share, which supports therapeutic rapport and informs safety planning and treatment decisions.

When supporting a patient with paranoid delusions and voices, the goal is to validate the experience and stay engaged rather than argue about what’s real. The best response is to invite the patient to describe the voices and what they are saying. This open-ended question shows you are listening, lowers defensiveness, and helps you gather important information about the content, level of distress, and any safety concerns. It also helps you assess whether the voices are commanding or otherwise risky, so you can plan appropriate care.

Saying the voices aren’t real dismisses the patient’s experience and can damage trust. Ignoring the voices or telling the patient to stop talking about them leaves distress unaddressed and can increase agitation or risk. By asking what the voices are saying, you create a safe space for the patient to share, which supports therapeutic rapport and informs safety planning and treatment decisions.