MGH Home SchoolPsychiatry Home Page
School-Based Interventions : Psychosis
Interventions for Hallucinations/Delusions


  1. Identify and avoid the student's exposure to known distressing stimuli

    Clarify with the student or family the items, places, or topics that trigger delusional thinking and find alternatives, particularly when the student is stressed or currently experiencing psychosis symptoms ("Starry, Starry Night" painting by van Gogh distresses student, so take it down and replace with more organized, less animated art).
  2. Provide the student with grounding activities

    Provide the student familiar, predictable activities throughout the day to keep the student aware of where he/she is (non-emotional reading content, familiar rituals such as taking attendance, check-in questions ["what are you doing this afternoon?"], reciting the pledge of allegiance or class mission).


  • Allow the student alternative schoolwork or activities to avoid provoking delusions

    If the student cannot proceed with a task, provide an alternative, "grounding" task which requires little creativity, such as reading, moving items, or doing rote tasks. top

Behavioral Planning

  • Devise steps to employ when the student is delusional or hallucinating

    Employ a series of steps to de-escalate the student when he/she is becoming more delusional (first: change topic, second: change activity, third: change setting, fourth: change staff).
  • Provide a hierarchy of safe places to de-escalate if the student is over-stimulated

    Identify several places, based on where the student is likely to be at different times during the school day, that feel safe and help to ground the student (in morning classes the student can go to the cafeteria, at lunch he/she can go to the special education classroom, in the afternoon he/she can go to the library or gym if there are too many people in the library). top
    ©2010 Massachusetts General Hospital, School Psychiatry Program and MADI Resource Center
    Copyright | Disclaimer | Privacy Policy | Department of Psychiatry  | Site Map