This disorder is characterized by the presence of non-bizarre delusions, which have persisted for a least one-month. Non-bizarre delusions typically are beliefs of something occurring in a persons life, which is not out of the realm of possibility. For example, the person may believe their significant other is cheating on them, that someone close to them is about to die, a friend is really a government agent, etc. All of these situations could be true or possible, but the person suffering from this disorder knows them not to be. People who have this disorder generally dont experience a marked impairment in their daily functioning in a social, occupational or other important setting. Outward behavior is not noticeably bizarre or objectively characterized as out-of-the-ordinary.
The three main treatments associated with delusional disorder are psychotherapy, medications and self-help. According to Long 1995-97, psychotherapy is usually the most effective help to people who suffer from delusional disorder. The most important factor in this therapy is the quality of the patient / therapist relationship. Trust is the key issue, as is unconditional support (Long 1995-97).
Once a firm, supportive therapeutic relationship has been established, the therapist can begin reinforcing positive gains and behaviors the individual makes in his or her life, such as in educational or occupational gains. It is important to reinforce these life events because it reinforces in the patient a sense of self-confidence and self-reliance. Even though psychotherapy is the most effective, according to Long 1995-97, it may not be all that helpful because the patient / therapist relationship will never exist so therefore neither will the trust. If that relationship between the patient / therapist never exists then the two will never feel comfortable working together. The patient may think that the therapist thinks that they are crazy and therefor will never build any trust, and again trust is the key issue. Clinicians should always be very direct and honest, especially with people who suffer from delusional disorder, and if this doesnt happen then psychotherapy will not work.
Only when the client has begun to feel more secure in their social or occupational world can more productive work be accomplished in therapy. This involves the gradual but gentle challenging of the clients delusional beliefs, starting with the smallest and least-important items. If the patient refuses to give up his or her delusional beliefs, even the small ones, then therapy is likely to be very long-term. According to Long 1995-97 if the patient gives up the delusional beliefs and trust their therapist the n the psychotherapy will be effective. Medication is the second form of help for people who have delusional disorder (Clayton, 1997). Suggesting the use of medication for this disorder, while possibly indicated to help temporarily relieves the delusions, is usually difficult.
The client may be suspicious of any professional suggesting the use of medication and therefore the treatment approach if problematic. Anti-psychotic medication is the preferred medication used; though it is only marginally effective according to Clayton, 1997. There are few studies done which confirm the use of any specific medications for this disorder. Hospitalization should be avoided at all costs, since this will usually go to reinforce the individuals distorted cognitive schema.
Partial hospitalization and or day treatment programs are preferred to help manage individual under close supervision on a daily basis. Self-help is the third kind of treatment for delusional disorder. There are not many self-help support groups or communities that would be conducive to someone suffering for this disorder. Such approaches would likely not be very effective because a person with this disorder is likely of be mistrustful and suspicious of others and their motivations, making group help and dynamics unlikely and possibly harmful (Alford, 1994).
I feel sorry for the people who have delusional disorder because there isnt one effective way that would really help them. Psychotherapy may help them the best, but from what I know it may not help them at all. Same with the medications, there also isnt one medication out there that will effectively help patients with this disorder. And there are no self-help groups out there to realistically help them so I dont even know why this option is considered. This is a disorder that needs to be concentrated on to finding an effective way of curing it..