A 40-year-old male with a history of schizophrenia appears frightened and sees snakes. How should you respond?

In the context of psychiatric care, particularly with individuals experiencing hallucinations, an effective approach involves acknowledging the patient's experience without validating their delusions. Telling the patient that you do not see any snakes allows you to ground the conversation in reality while also addressing their feelings. It is a way to open up dialogue without dismissing their experience entirely.

This response is important because it helps to establish trust, allowing the patient to feel heard while differentiating between their perception and the shared reality. It can prevent escalation of fear and confusion by not imposing your reality on theirs in a way that could seem dismissive. It also encourages the patient to express further thoughts about what they are experiencing, which can be helpful for assessment and intervention.

In contrast, stating that going to the hospital will keep him safe, discussing medication compliance, or urging for transportation can be perceived as more authoritative and could increase the patient's fear or anxiety, potentially exacerbating their symptoms rather than providing the reassurance and understanding that is essential in such situations.