In addition, this client was initially diagnosed with schizophrenia when he was 22 years old. He stated that during this time, he was hearing voices of a commentary nature and was also experiencing paranoid ideation. Working as a labourer at a building site, he reported that he felt somewhat paranoid regarding his fellow labourers and started suspecting that they were making plans to harm him or his family. The client has some lingering paranoia ideas evident with regard to his previous workmates at the building site. However, these paranoia ideas are short-lived in their nature and whenever they occur they happen to be less disturbing. Client exhibited suicidal ideation.

Bernard can take anti-psychotic medications.

·         Maintain a safe environment.

·         Stay with the client when he starts to hallucinate, and direct him to tell the voices he is hearing to go away.

·         Do not argue with him about his delusions or hallucinations (Edwards et al., 2011).

·         Tell the client that the delusions or hallucinations are symptoms of a psychiatric disorder.

·         Acknowledge fear or feelings

·         Try to keep the client engaged

·         Do not express approval

·         Keep communication non-judgmental and open (Köhler et al., 2013).

·         Encourage client to practice some techniques of relaxation

·         Assist the client to control delusions or hallucinations by focusing on reality and taking necessary medications as prescribed.

·         Be tactful in approach

·         Utilize distractions, hobbies, exercising, saying stop (Davis et al., 2016).

·         Maintain consistency

·         Encourage and reassure the client

·         Listen to the client and respect his feelings

·         Clearly explain what you are doing and the reason as to why.

·         Assist him in identifying the needs which may underlie the hallucinations. What other ways could those needs be satisfied? Hallucinations could reflect needs for sexuality, self-esteem, power and anger (Beck, 2014).

·         Do not touch Bernard without first informing him exactly what you are trying to do.

·         Do not tease or joke with Bernard.

·         Assist Bernard to differentiate between reality and his own thoughts. Confirm the presence of delusions or hallucinations. Identify hallucinations or delusions as being symptoms of the disorder and tell him that hallucinations or delusions are present due to the metabolic changes taking place inside his brain. Centre on the reality-oriented facets of the communication (Fleury et al., 2013).

·         Administer antipsychotics agents such as Risperdal, Zyprexa and Gedon, as prescribed. Inform Bernard about the side effects of the medicine, as well as dose of medication. Give emphasis to the significance of taking medicines following discharge, even when the symptoms have totally gone away. Ask Bernard to be committed in taking the medicine (Yamasaki et al., 2016).

Psychiatrist will provide non  pharmacotherapy  intervention

·         Assess the ability of the client to conduct activities of daily living and pay special attention to his nutritional status (Loebel, Lieberman & Alvir, 2013).

·         Provide supportive group therapy that focuses on the here-and-now, create group norms which discourage improper social behaviour, and encourage the client to test new social behaviour.

·         Role-play particular established social behaviours. Promote growth of relationships amongst group members by means of self-disclosure and realness. Encourage the members of the group to confirm their perceptions with other people (Oya, Kishi & Iwata, 2014).

·         Monitor patient’s compliance with medication routine. Encourage the client to be present at medication group. Ask the client about particular symptom exacerbations and side effects. Encourage the client to go to regular symptom management groups.

·         Recognize the environments wherein social interactions are impaired such as leisure, living, working, and learning.

·         Role-play different facets of social interactions like asking for something, starting or terminating a conversation, asking somebody to take part in a certain activity such as going to watch a movie, refusing a request, or even interviewing for a job (Wai Tong et al., 2016). Give Bernard positive feedback. Focus at most on 3 behavioural connections at a time.

·         Assist community members and client’s family to understand Bernard and give him necessary support. With the permission of the client, form an alliance with the family. Encourage members of his family to attend a support group (Chow 2012).

Psychiatrist will provide non  pharmacotherapy  intervention

Family members and community members will be understanding to Bernard and give him support

·         Encourage the client to observe healthy habits that will help to optimize functioning such as working well with others at the building site, maintaining a regular pattern of sleep, and maintaining medication regimen. These are helpful in keeping the patient in remission (Kopelowicz, 2012).

·         Engage patient in reality-oriented activities involving human contact such as outpatient day care, sheltered workshops, and inpatient social skills training groups.

·         Reward positive behaviour to assist Bernard improve his functioning level (Edwards et al., 2011).

Psychiatrist will provide non  pharmacotherapy  intervention

Family members and community members will be understanding to Bernard and give him support

Bernard can stick to the treatment regime

·         Be alert for signs of growing agitation, anxiety or fear. May be indication of hallucinatory activity that could be really frightening to Bernard, and he may act upon command hallucinations for instance by harming others or himself (Kohler et al., 2013).

·         Intervene with seclusion, one-on-one or pharmacological/ medication treatments for depression and stress.

·         Also use psychotherapeutic and somatic interventions and psychoeducation.

·         Intervene before the anxiety starts to increase. If Bernard is already out of control, utilize physical or chemical restraints following unit protocols (Davis et al., 2016).

Psychiatrist will provide non  pharmacotherapy  intervention