Assisting the Emotionally Distressed Student

The Student in Poor Contact With Reality


Students in poor contact with reality have difficulty distinguishing "fantasy" from real life. Their thinking is typically illogical, confused, or irrational (e.g. speech patterns that jump from one topic to another with no meaningful connection); their emotional responses may be incongruent or inappropriate; and their behavior may be bizarre and disturbing.

A student with poor contact with reality may experience hallucinations, often auditory, and may report hearing voices (e.g. someone is/will harm or control them). While this student may elicit alarm or fear from others they are generally no more violent then anybody else. However, there are some situations in which they can become violent, especially when experiencing "command hallucinations." These hallucinations are telling them what to do, such as "you must destroy that evil person."

When working with students who are experiencing poor contact with reality:

 

 

Table of Contents

 

Introduction

Intervention, Consultation and Referral

The Anxious Student

The Suspicious Student

The Depressed Student

The Suicidal Student

The Student in Poor Contact with Reality

The Student Under the Influence

Violence and the Verbally Aggressive Student

Departmental Safety Plan

Counseling Center Services



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It is helpful to

  • Acknowledge their feelings or fears without supporting the misperceptions (e.g., "I understand you think someone is following you, right now I don't see anyone and I believe you are safe")
  • Remove extra stimulation from environment (turn off radio outside a noisy classroom)
  • Talk in a calm and soft voice while stating your concern and verbalizing that they need some help
  • Acknowledge your difficulty understanding them and ask for clarification
  • Respond with warmth and kindness. Use firm reasoning
  • Focus on what you observe in the "here and now"
  • Consult with or refer them to the Counseling Center as soon as possible if you cannot make sense of their conversation or if you are concerned about their behavior

It is not helpful to

  • Argue or try and convince them of the irrationality of their thinking, as this commonly produces a stronger defense of the false perception
  • Play along, "Oh, yes, I hear the voices."
  • Encourage further discussion of the delusional process
  • Demand or order them to do something to change their perceptions
  • Expect customary emotional responses



Counseling Center
Veitch Student Center
North Wing
University of California, Riverside
Riverside, CA 92521-0320
Phone: (951) 827-5531
Fax: (951) 827-2015