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Poor Contact with Reality

Students with poor reality testing have difficulty distinguishing fantasy from reality. Their thinking is typically illogical, confused or irrational (e.g., jumping from one topic to another with no connection); their emotional responses may be incongruent or inappropriate; and their behavior may be bizarre and disturbing. They may experience hallucinations and may report hearing voices.

Their academic work (classroom speech or written assignments) may be unintelligible and they may use words that don’t make sense. While this student may illicit alarm or fear from others, they are generally not dangerous or violent. If you cannot make sense of their conversation or work, you should contact Counseling and Psychological Services as soon as possible.

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


  1. 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.”)
  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 they need help.
  4. Acknowledge your difficulty in understanding them and ask for clarification
  5. Respond with warmth and kindness but use firm reasoning.
  6. Focus on the here and now.
  7. Be aware that the student may show no emotions or intense emotions.
  8. Be aware that the student may be extremely fearful to the extent of paranoia.
  9. Be aware that the student may not understand you or understand only pieces of what is being said.
  10. If the student is an immediate danger to themselves or others, call BYU Police (801.422.2222) for assistance.
  11. If the student is not in immediate danger of hurting themselves or others, but you are very concerned and would like to consult, call Counseling and Psychological Services (801.422.3035) during working hours. After work hours the on-call counselor can be reached through BYU Police (801.422.3035).
  12. When possible, accompany the student to Counseling and Psychological Services (WSC 1500). If you feel extremely uncomfortable with the student, or if you are unable to accompany the student to one of these services, please contact Counseling and Psychological Services (801.422.3035) for consultation.