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Difficulty: HardTherapeutic Communication

A nurse is caring for a young adult client who has just received a diagnosis of HIV. The client is staring at the floor and states in a quiet voice, "I cannot tell my family about this. If they find out, they will completely disown me and I will have no one left." Which of the following is the most therapeutic response by the nurse?

  1. It sounds like you are feeling deeply afraid of being rejected and left completely alone.Answer
  2. B
    You should give your family a chance; you might be surprised by how supportive they can be during a crisis.
  3. C
    Why are you so convinced that your family will immediately cut all ties with you over a medical diagnosis?
  4. D
    I can provide you with information for local support groups that can help you if your family does not understand.

Answer

The most therapeutic response reflects the client's feelings by stating, "It sounds like you are feeling deeply afraid of being rejected and left completely alone."
The correct response utilizes reflection, an evidence-based therapeutic communication technique. By verbalizing the implied feelings of fear and isolation, the nurse demonstrates active listening and empathy. This validates the client's emotional experience and creates a safe, non-judgmental space for the client to explore their feelings further.

Step-by-Step Solution

1
Analyze the client's statement to identify the core emotion and underlying message.
The client is expressing severe anticipatory anxiety and a profound fear of abandonment and isolation due to their new diagnosis.
Understanding the primary emotional state is required before selecting an appropriate therapeutic technique.
2
Evaluate each nursing response against established principles of therapeutic communication.
Identify responses that validate the client's feelings versus those that introduce communication barriers such as giving advice, false reassurance, or probing.
Therapeutic communication aims to keep the focus on the client's feelings and encourage open dialogue.
3
Select the response that best facilitates the therapeutic relationship and encourages the client to elaborate.
The reflective statement accurately mirrors the client's fear of rejection without judging, advising, or reassuring prematurely.
Reflection is a powerful technique that demonstrates empathy, active listening, and allows the client to feel heard and understood.

Key Concept

Therapeutic Communication: Reflection and Validation
Estimated Time:1m 15s
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Topics

Therapeutic Communication

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