The nurse is attempting to de-escalate a client who is becoming increasingly agitated on the unit. Which of the following interventions would be appropriate for this type of client? (SELECT ALL THAT APPLY)

Choice A Reason:

Restating involves repeating what the client has said in order to show understanding and to encourage them to continue talking. This technique helps to clarify the client’s thoughts and feelings, ensuring that the nurse accurately understands the client’s message. It also demonstrates active listening and empathy, which are crucial components of therapeutic communication.

Choice B Reason:

Giving advice is generally considered a non-therapeutic communication technique. It can imply that the nurse knows best and can undermine the client’s autonomy and decision-making abilities. Instead of giving advice, therapeutic communication focuses on helping clients explore their own thoughts and feelings to arrive at their own conclusions and solutions.

Choice C Reason:

Maintaining neutral responses involves responding to the client in a way that does not convey judgment or bias. This technique helps to create a safe and supportive environment where the client feels comfortable sharing their thoughts and feelings. Neutral responses can include nodding, making non-committal sounds like “mm-hmm,” and using phrases like “I see” or “Tell me more”.

Choice D Reason:

Asking the client “Why?” can be perceived as confrontational or judgmental, which can hinder open communication. It may make the client feel defensive or uncomfortable. Instead, therapeutic communication techniques involve asking open-ended questions that encourage the client to express themselves without feeling judged.

Choice E Reason:

Listening is one of the most fundamental therapeutic communication techniques. It involves giving the client your full attention, showing interest in what they are saying, and responding appropriately to their concerns. Active listening helps to build trust and rapport, making the client feel heard and understood.

Choice A Reason:

Draws attention and approval from significant others.

This statement is incorrect. Compulsive washing rituals in Obsessive-Compulsive Disorder (OCD) are not typically performed to draw attention or gain approval from others. Instead, these rituals are driven by an internal need to reduce anxiety and distress associated with obsessive thoughts. The primary function of these behaviors is to manage the individual’s own anxiety rather than to seek external validation.

Choice B Reason:

Provides temporary and partial relief from anxiety.

This is the correct response. Compulsive washing rituals in OCD are performed to alleviate the intense anxiety and distress caused by obsessive thoughts. Although the relief is temporary and partial, it reinforces the behavior, creating a cycle where the individual feels compelled to repeat the ritual to manage their anxiety. This temporary relief is a key characteristic of compulsive behaviors in OCD.

Choice C Reason:

Increases the inhibitory powers of their superego.

This statement is incorrect. The concept of the superego is related to Freud’s psychoanalytic theory, where it represents the internalized moral standards and ideals. Compulsive washing rituals in OCD are not performed to increase the inhibitory powers of the superego but rather to reduce anxiety and distress. The rituals are a response to obsessive thoughts rather than a means of enhancing moral inhibition.

Choice D Reason:

Blocks delusions and hallucinations from awareness.

This statement is incorrect. Delusions and hallucinations are more commonly associated with psychotic disorders, such as schizophrenia, rather than OCD. Compulsive washing rituals in OCD are not intended to block delusions or hallucinations but to manage anxiety related to obsessive thoughts. The focus of these rituals is on reducing distress rather than addressing psychotic symptoms.