Two low-cost interventions for grandiose delusions

Indonesian nurse-researchers tested simple non-pharmacological approaches in a single case of schizophrenia with grandiose delusions.

Nurses and researchers from Universitas Padjadjaran in Indonesia tested two simple, low-cost non-pharmacological interventions on a 21-year-old man with schizophrenia who was experiencing grandiose delusions, meaning he held strong false beliefs about having exceptional power, status, or identity. Over four sessions across one week, each lasting 15 to 30 minutes, the patient played card matching games and wrote in a journal for self-reflection. The card game was designed to improve concentration and the ability to follow rules, two skills that are often disrupted when delusions dominate thinking. The journaling component asked the patient to write down his thoughts and gradually work toward recognizing which beliefs were disconnected from reality. By the end of the week, the patient showed reduced intensity in his grandiose beliefs, better concentration, more controlled behavior, and speech that more closely matched reality. The researchers are clear that this didn't result in full recovery, and the interventions worked best alongside the patient's existing medication. The broader point the paper makes is that structured activities grounding someone in rules, sequencing, and concrete self-reflection may help counteract the reality distortion of delusions as part of a combined care approach.