Supporting a Student in Poor Contact with Reality

In some instances, as a faculty or staff member, you may interact with a student who is having difficulty with connecting to reality. While this can be a challenging experience, and may require you to deescalate an interaction, it is important to note that these students generally do not pose an immediate physical threat to themselves or others.

Students in Poor Contact with Reality

These students have difficulty distinguishing fantasy from reality. Their thinking is typically illogical, confused, or irrational (e.g., speech patterns jump from one topic to another with no meaningful connection); their emotional responses may be incongruent or inappropriate; and their behavior or comments may be perceived as bizarre and as a result can be disturbing. Their communication and academic work (classroom speech or written assignments) may be unintelligible, and they may use words that don’t make sense. This student may experience hallucinations (e.g.,may report hearing voices) or experience delusions (e.g., someone is/will harm or control them, they may have supernatural powers).

While this student may elicit alarm or fear from others, they generally are not dangerous or violent. If you cannot make sense of their conversation, consult with, or refer to Counseling Services or the Office of the Dean of Students as soon as possible.

If the student is an immediate danger to self or others, call 911 for assistance.

When Interacting with Students with a Poor Connection to Reality

It is helpful to:

  • Acknowledge their 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.”).
  • Remove extra stimulation from the environment (i.e., step outside of the classroom, turn off any music, etc.).
  • Acknowledge your concerns and verbalize that they need help.
  • Acknowledge your difficulty in understanding them and ask for clarification.
  • Respond with warmth and kindness but use firm reasoning.
  • Focus on the here and now.
  • Be aware that the student may show no emotions or intense emotions.
  • Be aware that the student may be extremely fearful to the extent of paranoia.
  • Be aware that the student may not understand you or understand only pieces of what is being said.
  • If the student is not in immediate danger of hurting themselves or others, but you are very concerned call ahead to Counseling Services (541-346-3227) and ask to speak to department leadership to discuss whether it would be appropriate to send or bring the student to that office or to take/send them to a different resource. If the student will be seen at Counseling Services, accompany them if possible and you feel comfortable doing.
    • If this is after hours, you can call the Counseling Services After-Hours Support and Crisis Line (541-346-3227) to consult with a mental health professional or call the UO Police Department’s nonemergency phone number (541-346-2919) for support.
  • If other students have been impacted by this student’s behavior, please contact the Office of the Dean of Students (541‑346‑3216).

It is less helpful to:

  • Argue or try to convince them of the irrationality of their thinking as this commonly produces a stronger defense of the false perception.
  • Play along (e.g., “Oh yes, I hear the voices too” etc.).
  • Encourage further discussion of the delusional processes.
  • Demand, command or order them to do something to change their perceptions.
  • Expect customary emotional responses.

Adapted from: University of Washington