A patient with paranoid delusions refuses to eat; which approach is most therapeutic?

• A. Repeat the accusation
• B. Tell the patient the food is not poisoned
• C. Acknowledge fear and ask what makes you feel the food is poisoned
• D. Force-feed the patient

Answer: (C)

When a patient has paranoid delusions about food, the most therapeutic move is to acknowledge the fear and invite them to share what makes them feel the food is poisoned. Validating their feelings without arguing against the delusion helps reduce defensiveness and builds trust, which is essential for any subsequent care. By asking what specifically leads them to believe the food is poisoned, you gain insight into their concerns and can address concrete fears, negotiate safer options, and gradually work toward improved eating patterns. This approach emphasizes empathy, active listening, and collaborative problem‑solving rather than confrontation.

Repeating accusations, insisting the food isn’t poisoned, or forcing food breaks trust and can escalate paranoia or lead to coercive, unsafe practices.