A nurse is planning care for a client who has chronic substance use disorder. Which of the following is the most therapeutic response to help the client cease alcohol consumption?
"Let me tell you how I struggled to stop drinking whiskey over the years, but finally succeeded."
"You have stopped drinking, haven't you?"
"The physician has ordered you to stop drinking all alcoholic beverages. Are you going to make us happy?"
"Let's work together on a plan that includes medication, group support, and counseling."
The Correct Answer is D
Rationale:
A. Sharing personal experiences can be supportive, but it may not be the most therapeutic or professional approach in this situation.
B. This question is leading and doesn't encourage an open dialogue. It may also induce guilt or defensiveness in the client.
C. This statement is authoritative and may come across as coercive, which can be counterproductive in encouraging the client to take responsibility for their recovery.
D. Collaborating with the client on a comprehensive plan that includes medication, group support, and counseling is a therapeutic approach that empowers the client to actively participate in their recovery, offering them the best chance of success.
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Correct Answer is D
Explanation
Rationale:
A. This statement may indicate prolonged grief or depression but does not specifically point to the guilt or distress seen in traumatic grief.
B. This describes a physiological response to flashbacks, which is more indicative of post-traumatic stress disorder (PTSD) rather than traumatic grief.
C. This statement reflects emotional suppression, which can be common in military culture but does not directly indicate traumatic grief.
D. Expressing survivor's guilt, as in feeling that they should have died instead of their friend, is a hallmark of traumatic grief and indicates the client is struggling with the loss in a deeply distressing way.
Correct Answer is A
Explanation
Rationale:
A. Listening attentively and summarizing the client's comments are key techniques in developing a therapeutic relationship, as they demonstrate understanding, empathy, and engagement.
B. Asking questions that elicit only one-word responses limits the depth of conversation and does not encourage clients to express their feelings or concerns.
C. Avoiding direct questions about suicidal behaviors or thoughts is not appropriate, as addressing these concerns directly is crucial in assessing and ensuring client safety.
D. Allowing the client’s family to attend all group therapies may not always be appropriate, as it could impede the client’s ability to express themselves freely and might not be suitable for all therapeutic settings.