A nurse is caring for a client with OCD who is taking a selective serotonin reuptake inhibitor (SSRI) The client reports that they are having difficulty sleeping. Which of the following interventions should the nurse recommend?

Choice A rationale:

Family history of OCD is a significant risk factor for developing the disorder. Genetic predisposition plays a role in the etiology of OCD, with a higher likelihood of the disorder occurring in individuals who have close relatives (e.g., parents or siblings) with the condition. While environmental factors and life experiences can contribute to OCD, they are not as directly linked as the genetic component.

Choice B rationale:

History of childhood trauma can contribute to the development of various mental health disorders, including anxiety and OCD. However, the strongest association with OCD is the genetic component. While childhood trauma can exacerbate symptoms in individuals who are genetically predisposed, it is not the most likely finding in the medical record of a client with OCD.

Choice C rationale:

Head injury can lead to neurological and psychological changes, potentially contributing to various psychiatric conditions. However, the primary cause of OCD is not head injury. It is important to consider the presence of other factors, especially the genetic predisposition, when attributing OCD to a particular cause.

Choice D rationale:

Brain tumor is an organic condition that can cause neurological and psychological symptoms. However, brain tumors are not a common or primary cause of OCD. The focus in the etiology of OCD is on neurotransmitter imbalances, genetic factors, and brain circuitry, rather than structural brain abnormalities like tumors.

Choice A rationale:

The nurse should not tell the client to stop their behaviors immediately, as this approach is likely to increase anxiety and distress. Individuals with obsessive-compulsive disorder (OCD) often find it challenging to abruptly stop their compulsions, and attempting to do so can lead to heightened anxiety.

Choice B rationale:

Distracting oneself from the urge to perform compulsions might provide temporary relief, but it does not address the underlying issues of OCD. It is essential to work on strategies that target the reduction of compulsions and the management of anxiety associated with them.

Choice C rationale:

Giving in to compulsions might temporarily relieve anxiety, but it reinforces the cycle of OCD behavior. Encouraging the client to give in to compulsions is counterproductive to the treatment of OCD, which involves breaking the pattern of compulsive behavior.

Choice D rationale:

This is the correct choice. Collaboratively developing strategies to gradually reduce compulsive behaviors is a standard approach in treating OCD. This method is aligned with exposure and response prevention therapy, a well-established treatment for OCD. By gradually facing the situations that trigger obsessive thoughts and then refraining from performing compulsions, clients can learn to manage their anxiety and reduce their reliance on compulsive behaviors.