After restraints are removed, a patient yells about bugs, claiming bugs are all over. Which is the best initial response?

After restraints are removed, a patient yells about bugs, claiming bugs are all over. Which is the best initial response?

• A. Just hold very still and the bugs will crawl away.
• B. Don't worry, those are just little bugs, they won't hurt you.
• C. You're seeing bugs because of your disorder, but I don't see any bugs on you.
• D. What kinds of bugs are on you?

Answer: (C)

When a patient is distressed by a psychotic symptom like a delusion of infestation, respond with calm, validating language that also grounds them in reality without arguing about what they perceive. Saying, “You’re seeing bugs because of your disorder, but I don’t see any bugs on you,” does just that: it acknowledges the fear and links it to the condition, while gently giving an objective reality check. This approach helps reduce anxiety, preserves trust, and keeps the door open for further assessment and care, without dismissing the patient or escalating the situation. Options that command compliance or minimize the experience can increase agitation or distrust, while probing about the bugs can reinforce the focus on the delusion.

When a patient is distressed by a psychotic symptom like a delusion of infestation, respond with calm, validating language that also grounds them in reality without arguing about what they perceive. Saying, “You’re seeing bugs because of your disorder, but I don’t see any bugs on you,” does just that: it acknowledges the fear and links it to the condition, while gently giving an objective reality check. This approach helps reduce anxiety, preserves trust, and keeps the door open for further assessment and care, without dismissing the patient or escalating the situation. Options that command compliance or minimize the experience can increase agitation or distrust, while probing about the bugs can reinforce the focus on the delusion.