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Zorluk: Çok zorTherapeutic Communication

A 19-year-old client with a history of major depressive disorder is admitted to the medical-surgical unit after a severe acetaminophen overdose. The client is medically stable but refuses eye contact and states flatly to the nurse, "I don't know why you all worked so hard to save me. I'm just going to try again the minute I get out of here. Nothing is ever going to get better." Which of the following responses by the nurse demonstrate the effective use of therapeutic communication? Select all that apply.

  1. "You are feeling like your situation is completely hopeless right now."Cevap
  2. B
    "I understand you are feeling overwhelmed, but things will look brighter once your new medication starts working."
  3. Sitting quietly by the client's bedside while maintaining an open, attentive posture.Cevap
  4. D
    "Why do you believe that attempting to end your life again is the only answer for you?"
  5. E
    "Let us focus on clearing the acetaminophen from your system today; we can discuss these feelings tomorrow."
  6. "It sounds as though you are angry that our medical team intervened to save your life."Cevap

Cevap

The therapeutic responses are: reflecting the client's hopelessness, utilizing active silence, and verbalizing the client's implied anger toward the medical team.
Therapeutic communication aims to build trust, validate the client's emotional experience, and encourage exploration of feelings without judgment. Stating that the client feels hopeless is a direct reflection of feelings, which validates their current emotional state. Sitting quietly utilizes active therapeutic silence, providing a supportive presence that allows the client time to process emotions without feeling pressured to speak. Verbalizing the implied anger regarding the medical intervention acknowledges the client's unspoken feelings and demonstrates deep empathy, encouraging further dialogue.

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1
Analyze the client's statement and underlying emotional state.
The client is expressing profound hopelessness, active suicidal intent, and frustration regarding the medical intervention.
Understanding the core emotions (despair and anger) is necessary to select responses that directly address and validate these feelings.
2
Identify the goal of the nurse's response in this crisis moment.
The primary goal is to validate the client's emotional pain, encourage open expression, and maintain a safe, non-judgmental presence.
In psychiatric emergencies, establishing rapport and demonstrating deep empathy takes precedence over offering solutions or defending medical actions.
3
Evaluate each option against therapeutic communication principles.
Reflecting feelings (Option A), offering silence (Option C), and verbalizing implied emotions (Option F) all meet the criteria for therapeutic communication.
These techniques keep the focus squarely on the client's emotional experience without adding pressure.
4
Eliminate options containing non-therapeutic communication barriers.
False reassurance (Option B), asking "why" (Option D), and deflecting/changing the subject (Option E) are eliminated.
These barriers block further communication, make the client feel misunderstood, and fail to address the immediate psychological distress.

Anahtar Kavram

Therapeutic Communication with a Suicidal Client
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Konular

Therapeutic Communication

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