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Tiffany is a 16-year-old teenager who has obsessive-compulsive disorder and continually washes her hands until they are cracked and bleeding. She was placed on the inpatient unit on a 5150 after a recent suicide attempt in which she overdosed on her mother’s sleeping pills in the medicine cabinet. She is medically stable. You are her assigned nurse, and when you approach her room, you hear her in the bathroom washing her hands.Tiffany describes the ending of her relationship with her boyfriend as “ghosting.” He just “stopped calling me after a year of going out.” Important cognitive behavioral approaches for her lack of self-esteem and anxiety may be (select all that apply):

A.

Reframe “all or nothing” thinking and that it is all “her fault.”

B.

Have her identify self-soothing activities for decreasing anxiety.

C.

Reframe self-criticism and give positive feedback for insightful comments during group therapy.

D.

Tell her she “has her entire life ahead of her and shouldn’t be worried about her former boyfriend.”

Question Solution

Correct Answer : A,B,C

Choice A reason:

Reframing “all or nothing” thinking and that it is all “her fault” is an important cognitive behavioral approach. This technique helps Tiffany recognize and challenge irrational thoughts that contribute to her low self-esteem and anxiety. By learning to see situations in a more balanced way, she can reduce feelings of guilt and self-blame.

 

Choice B reason:

Having Tiffany identify self-soothing activities for decreasing anxiety is another effective cognitive behavioral approach. Self-soothing activities, such as deep breathing, listening to music, or engaging in hobbies, can help her manage anxiety and reduce the urge to engage in compulsive behaviors like handwashing.

 

Choice C reason:

Reframing self-criticism and giving positive feedback for insightful comments during group therapy can help Tiffany build self-esteem and develop a more positive self-image. Positive reinforcement encourages her to recognize her strengths and achievements, which can counteract negative self-perceptions.

 

Choice D reason:

Telling Tiffany she “has her entire life ahead of her and shouldn’t be worried about her former boyfriend” is not a cognitive behavioral approach. While it may be intended to provide reassurance, it does not address the underlying cognitive distortions or provide strategies for managing anxiety and low self-esteem.


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View Related questions

Correct Answer is C

Explanation

Choice A reason:

Being afraid of medical providers is not a determining factor for the suitability of rTMS. While patient comfort and willingness to undergo treatment are important, the primary considerations for rTMS eligibility are medical and safety-related.

Choice B reason:

His family’s agreement to take him to the hospital each week is supportive but not a primary criterion for rTMS eligibility. The focus should be on the patient’s medical suitability and safety for the procedure.

Choice C reason:

Signing an informed consent and having no presence of metal in the area of the magnetic stimulation, such as cochlear implants or medication pumps, are critical factors for rTMS eligibility. Metal implants in the head or neck can interfere with the magnetic fields used in rTMS, posing safety risks. Informed consent ensures that the patient understands the procedure, risks, and benefits.

Choice D reason:

Being angry about the death of his father is an emotional response and does not impact the medical suitability for rTMS. The decision to use rTMS should be based on medical criteria and safety considerations.

Correct Answer is ["A","B","C","D"]

Explanation

Choice A reason:

Supportive friends and family members play a crucial role in the recovery process for individuals with depression. Social support can provide emotional comfort, reduce feelings of isolation, and encourage adherence to treatment plans. Having a strong support network can significantly improve mental health outcomes.

Choice B reason:

Attending outpatient therapy or a partial hospital program offers structured support and treatment for individuals with depression. These programs provide access to mental health professionals, group therapy, and other therapeutic activities that can help manage symptoms and promote recovery. They offer a higher level of care than standard outpatient visits but do not require full hospitalization.

Choice C reason:

Consistent daily structure and exercise that is not overwhelming can help manage depression by providing routine and physical activity. Regular exercise has been shown to improve mood, reduce anxiety, and increase overall well-being. Establishing a daily routine can also help individuals with depression feel more in control and reduce feelings of chaos or unpredictability.

Choice D reason:

A well-balanced diet and restful sleep are essential components of mental health. Proper nutrition supports brain function and overall health, while adequate sleep is crucial for emotional regulation and cognitive function. Addressing these basic needs can help improve mood and energy levels, making it easier to cope with depression.

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