Personality and Mood Disorders Q 2
When caring for a client with a diagnosis of schizotypal personality disorder, the nurse should:
A. Set limits on manipulative behavior.
B. Encourage participation in group therapy.
C. Respect the client’s needs for social isolation.
D. Understand that seductive behavior is expected.
Correct Answer: C. Respect the client’s needs for social isolation.
These clients are withdrawn, aloof, and socially distant; allowing distance and providing support may encourage the eventual development of a therapeutic alliance. Group therapy would increase this client’s anxiety; cognitive or behavioral therapy would be more appropriate.
Option A: In a respectful, neutral manner, explain expected client behaviors, limits, and responsibilities during sessions with 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 the client can expect from the nurse. Clients need to be fully aware that they will be held responsible for their behaviors.
Option B: 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 D: Intervene in manipulative behavior. All limits should be adhered to by all staff involved. Behaviors should be documented objectively (give times, dates, circumstances). Provide clear boundaries and consequences. The client will test limits, and, once they understand that the limits are solid, this understanding can motivate them to work on other ways to get their needs met. Hopefully, this will be done with the nurse clinician throughout problem-solving alternative behaviors and learning new effective communication skills.