INTERVENTIONS

FORDIFFICULT CLIENTS
Withdrawn, depressed, suicidal,
anxious, violent, compulsive,
manipulative, dependent, paranoid,
delusional, hallucination, somatization
Care of client who is
WITHDRAWN
 Care of client who is
SUSPICIOUS (GUDS)
• Give client ample personal space
– To enhance his/her sense of security
• Use no demand attitude
– Making demands and being authoritative increases the client’s
fear
• Develop trust
– Be reliable and consistent
• Safety for others and client
– Approach client in a non-threatening manner
– Never whisper
– Never hold complicated objects
– Provide solitary and simple safe activities
 Care of client who is
DELUSIONAL (PAD)
• P - Present and maintain reality by making
simple statements
• A - Avoid reinforcing the delusional belief
by “playing along” with what the client says.
- Assess for potential for harm
• D - Do not openly confront the delusions or
argue with the client
- Distraction techniques: listening to music, watching tv,
talking to friends
- Direct actions: engaging in positive talk and ignoring
the delusional thoughts
Care of client who is with
HALLUCINATION
Care of client who is
DEPRESSED
 Care of client who is
SUICIDAL
• Assess high risk client (SAD PERSON scale)
– S – Sex
– A – Age
– D – Depression
– P – Previous Attempt
– E – Ethanol (Alcohol) use
– R – Rational thinking is impaired
– S – Social support is absent
– O – Oraganized plan
– N – No spouse
– S – Sickness
 Care of client who is
SUICIDAL
• Suicide precautions
– Make 24 hour close observation
– Provide one on one relationship
– Make “no-suicide” contract
Care of client who is
FEARFUL
Care of client who is
DEPENDENT
Care of client who is
AVOIDANT
Care of client who is
VIOLENT
Care of client who is
COMPULSIVE
Care of client who is
MANIPULATIVE
Care of client who is
SOMATIZATION