University of Vermont

Division of Student Affairs
Think. Care. Act.
Health and Safety

Poor Contact with Reality

These students have difficulty distinguishing fantasy from reality. Their thinking is typically illogical, confused or irrational. Additionally, emotional responses may be incongruent or inappropriate; and behavior may be bizarre or disturbing. These students may experience hallucinations and may report hearing voices. In some situations, academic work may be unintelligible and the student may use words that do not make sense.  If you cannot make sense of a student’s conversation or work, you should refer the student to Counseling and Psychiatry Services as soon as possible. You should also submit a C.A.R.E. Report 

When you encounter a student who displays irrational or inappropriate behavior or appears to be out of touch with reality:

DO

  1. Acknowledge the student’s feelings or fears without supporting the misconceptions (e.g., “I understand you think someone is following you, and it must seem real to you, but I don’t see anyone and I believe you are safe.”)
  2. Remove extra stimulation from the environment (i.e., step outside of the classroom, turn off any radios)
  3. Acknowledge your concerns and verbalize that the student needs assistance.
  4. Acknowledge the difficulty in understanding the student and ask for clarification.
  5. Respond with warmth and kindness but use firm reasoning.
  6. Be aware that the student may show no emotions or intense emotions.
  7. Be aware that the student may be extremely fearful to the extent of paranoia.
  8. Be aware that the student may not understand you or understand only pieces of what is being said.

DON’T

  1. Crowd the student’s personal space.
  2. Assume the student will be able to take care of him/herself when out of touch with reality.
  3. Agitate the student. Be flexible in the manner you proceed with the student.
  4. Argue with the student’s erroneous thought processes. Trying to convince them of the irrationality of their thinking commonly produces a stronger defense of the false perception.
  5. Play along (e.g., “oh yes, I hear the voices too.”) Don’t encourage further discussion of delusional processes.
  6. Don’t demand, command or order the student to do something to change their perceptions.
  7. Chase after a student who decides to run. Call (802) 656-3473 for assistance from UVM Police Services.
  8. Allow a student’s friends to take care of the student without getting a professional opinion.

Last modified March 19 2014 10:19 PM