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Zorluk: Çok zorTherapeutic Communication

An agitated client paces the hallway of a behavioral health facility and approaches the practical nurse. The client points to an empty corner and speaks rapidly, stating, "The walls are starting to breathe again. The provider promised the new medication would stop this, but the shadows are stretching out and they are coming to take me away tonight." Which response by the nurse represents the most appropriate therapeutic communication technique?

  1. A
    Can you describe exactly what the shadows look like and who you believe is coming to take you away?
  2. B
    You are completely safe here in the facility, and the nursing staff will not let anyone harm you tonight.
  3. I do not see the walls breathing or any shadows moving, but I can see that you are terrified. I will stay right here with you.Cevap
  4. D
    Try to remember that these visions are a symptom of your illness and they are not actually real.

Cevap

The response stating that the nurse does not see the walls breathing or shadows moving, acknowledging the client's terror, and offering to stay with them is the correct choice.
The correct response effectively utilizes three crucial therapeutic techniques for an actively psychotic client: presenting reality, validating feelings, and offering self. By explicitly stating that the nurse does not see the walls breathing or shadows moving, the nurse anchors the interaction in objective reality without arguing. Acknowledging that the client is terrified validates the intense emotional experience caused by the hallucination. Finally, offering to stay with the client provides the immediate safety and emotional support required during an acute psychiatric crisis.

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1
Analyze the client's current clinical and emotional state.
The client is actively experiencing visual hallucinations and severe fear/paranoia, requiring immediate grounding and safety.
Identifying the nature of the distress is required to select a communication technique that prioritizes safety without reinforcing pathology.
2
Evaluate the communication options against established mental health therapeutic techniques.
Exploring the details of the hallucination reinforces it. Offering protection validates the threat. Arguing logic dismisses the client's reality. Presenting reality while offering self is the standard of care.
Therapeutic communication in psychiatric care requires a delicate balance of maintaining reality while demonstrating profound empathy for the emotion caused by the delusion or hallucination.
3
Select the response that safely anchors the client to reality while addressing their emotional distress.
The response that clearly states the nurse's reality, validates the client's fear, and offers physical presence is the optimal choice.
This intervention provides safety and emotional support without crossing the boundary into validating psychotic symptoms.

Anahtar Kavram

Therapeutic Communication during Acute Psychosis
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Konular

Therapeutic Communication

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