1st Step Early Psychosis Intervention Program

HALLUCINATIONS (sensory experiences not shared by others)
Possible Signs:

• Pacing
• Restlessness
• Increased social withdrawal
• Increased preoccupations
• Irritability
• Talking to oneself

Coping Strategies:
Work with the person to develop a strategy of what is helpful for them. Identify and reduce what is causing them stress. See the doctor or mental health worker if necessary. Some tips to provide distraction are:

• Provide an activity e.g. a walk, card or board games, simple chores
• Encourage the person to have conversations with others
• Relaxation e.g. stress management tape
• Exercise
• Work
• Provide competing stimuli, e.g. portable stereo, tv, radio, movie

What Doesn't Work:

• Attempts to reason or debate with the voices

DELUSIONS (fixed, false beliefs: e.g. the person thinks they are a famous rap star or that the radio is sending messages just to them or that the RCMP is plotting against them)
Possible Signs:

• Fearfulness
• Suspiciousness
• Preoccupation
• Refusal to maintain routine/activities
• Irritability

Coping Strategies:

• Avoid debate, reasoning
• Acknowledge person's distress
• Avoid collusion
• Avoid interpreting the meaning of the delusion
• Speak about how the person is feeling. For example: If anxious talk about how to manage that anxiety or perhaps they are losing sleep and discuss how to manage that.
• Perhaps say: “I can see that those thoughts are making you feel very anxious (worried, upset, irritable etc). Let's work together to help you feel more relaxed.”

Delusions are part of the illness. Try to avoid emotional responses. Try to empathize with the fear, anxiety and distress.

THOUGHT DISORDER (thoughts seem confused, disorganized, sped up or slowed down)
Possible Signs:

• Incoherence
• Illogical
• Inappropriate emotional responses (e.g. laughs at very sad news)
• Pacing
• Restlessness
• Irritability
• Preoccupation

What Helps:

• Structured routine
• Limits to behaviour
• Simple words, short sentences
• Ask the person to repeat the instructions you gave them
• Lower the stimulation around them e.g. turn off radio, tv when speaking with them
• Do not provide too many choices as this may seem confusing right now