Research indicates that patients do not hold delusions with as fixed a
certainty as has been believed. Confrontation with reality may have an
important role in the evaluation and treatment of delusional patients. The
authors suggest four factors that may help predict the value of reality
confrontation in a given clinical situation: 1) how understandable the
delusion is in the context of the patient's life, 2) the degree of
conviction with which the patient holds the delusion, 3) the phase in
development of the delusional beliefs, and 4) the diagnosis of the
patient.
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