Alzheimer’s Delirium and Dementia Q 58
A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?
A. The parents reinforced increased decision-making by the client.
B. The parents clearly verbalize their expectations for the client.
C. The client verbalizes that family meals are now enjoyable.
D. The client tells her parents about feelings of low-self esteem.
Correct Answer: A. The parents reinforced increased decision making by the client
One of the core issues concerning the family of a client with anorexia is control. The family’s acceptance of the client’s ability to make independent decisions is key to successful family intervention. Discourage members from asking for approval from each other. Be alert to verbal or nonverbal checking with others for approval. Acknowledge the competent actions of the patient. Each individual needs to develop own internal sense of self-esteem. Individuals often are living up to others’ (family’s) expectations rather than making their own choices. Acknowledgment provides recognition of self in positive ways.
Option B: Identify patterns of interaction. Encourage each family member to speak for self. Do not allow two members to discuss a third without that member’s participation. Helpful information for planning interventions. The enmeshed, over-involved family members often speak for each other and need to learn to be responsible for their own words and actions.
Option C: Reinforce the importance of parents as a couple who have rights of their own. The focus on the child with anorexia is very intense and often is the only area around which the couple interacts. The couple needs to explore their own relationship and restore the balance within it to prevent its disintegration.
Option D: Although the remaining options may occur during the process of therapy, they would not necessarily indicate a successful outcome; the central family issues of dependence and independence are not addressed in these responses. Encourage and allow expression of feelings (crying, anger) by individuals. Often these families have not allowed free expression of feelings and need help and permission to learn and accept this.