Comprehensive exams for Mental Health Q 188
When planning care for Dory with a schizotypal personality disorder, which of the following would help the client become involved with others?
A. Attending an activity with the nurse.
B. Leading a sing along in the afternoon.
C. Participating solely in group activities.
D. Being involved with primarily one to one activities.
Correct Answer: C. Participating solely in group activities
Attending activities with the nurse assists the client to become involved with others slowly. The client with schizotypal personality disorder needs support, kindness & gentle suggestions to improve social skills & interpersonal relationships. Problem solve and role play with client acceptable social skills that will help obtain needs effectively and appropriately. Over time, alternative ways of experiencing interpersonal relationships might emerge. Take one small skill that the client is willing to work on, break it down into small parts, and work on it with the client.
Option A: Assess the need for and encourage skills training workshops. Skills training workshops offer the client wants to increase social skills through role-play and interactions with others who are learning similar skills. This often acts as a motivating factor where positive feedback and helpful suggestions are readily available.
Option B: In a respectful, neutral manner, explain expected client behaviors, limits, and responsibilities during sessions with the nurse clinician. Clearly state the rules and regulations of the institution and the consequences when these rules are not adhered to. From the beginning, clients need to have explicit guidelines and boundaries for expected behaviors on their part, as well as what clients can expect from the nurse. Clients need to be fully aware that they will be held responsible for their behaviors.
Option D: Expand limits by clarifying expectations for clients in a number of settings. When time is taken in initial meetings to clarify expectations, confrontations, and power struggles with clients can be minimized and even avoided. Understand that PD clients, in particular, will be resistant to change and that this is symptomatic of PDs. This is particularly true in the beginning phases of therapy. Responding to the client’s resistance and seeming lack of change in a neutral manner is part of the foundation for trust. In other words, the nurse does not have a vested interest in the client “getting better.”. The nurse remains focused on the client’s needs and issues in any event.