A nurse is using systematic desensitization with a client who has a phobia of heights. Which step should the nurse implement first?

Hallucinations are false sensory perceptions, often auditory, that are not based in reality. They commonly occur in psychotic disorders and may escalate under anxiety or stress. Managing hallucinations involves early recognition, reality testing, and strategies like therapeutic engagement. Anxiety can intensify perceptual disturbances, so interventions must address both symptoms. Clients should be taught to seek help, avoid isolation, and maintain stability through structured routines and medication adherence.

Rationale for correct answers

B. Seeking support and early intervention are key in managing hallucinations. Contacting a therapist when symptoms occur promotes safety and prevents progression into dangerous behavior.

Rationale for incorrect answers

A. Anxiety is a common side effect of psychotropic drugs and may also be a trigger for hallucinations, so this statement is inaccurate.

C. Support groups are useful for ongoing insight and coping, but they are not immediate interventions for acute hallucinations.

D. While sleep and nutrition are important, they are preventive—not active management strategies during hallucinations.

Take Home Points

• Hallucinations are often triggered or worsened by anxiety and stress.
• Early contact with mental health providers helps prevent escalation.
• Education should focus on active and practical responses to symptoms.
• Support groups are supplementary, not acute interventions.

Cognitive therapy aims to identify and modify distorted thinking patterns that lead to dysfunctional emotions and behaviors. It focuses on the present, is highly structured, and emphasizes reality testing of beliefs. This therapy is effective for depression, anxiety, and personality disorders, and often includes homework assignments to reinforce learning.

Rationale for correct answers

A. Thought identification and correction are central to cognitive therapy’s goal of improving emotional regulation through mental restructuring.

Rationale for incorrect answers

B. Insight into unconscious conflict is associated with psychoanalysis, not cognitive therapy.

C. Coping improvement is a secondary effect, not the direct goal.

D. Behavior change is part of CBT, but cognitive therapy specifically targets thinking.

Take Home Points

• Cognitive therapy targets how thoughts affect emotions.
• It focuses on present thinking, not past experiences.
• Distorted beliefs are identified and challenged.
• It's effective for a range of mood and anxiety disorders.