Personality and Mood Disorders Q 37
A client with schizotypal personality disorder is sitting in a puddle of urine. She’s playing in it, smiling, and softly singing a child’s song. Which action would be best?
A. Admonish the client for not using the bathroom.
B. Firmly tell the client that her behavior is unacceptable.
C. Ask the client if she’s ready to get cleaned up now.
D. Help the client to the shower, and change the bedclothes.
Correct Answer: D. Help the client to the shower, and change the bedclothes.
A client with schizotypal personality disorder can experience high levels of anxiety and regress to childlike behaviors. This client may require help needing self-care needs. The client may not respond to the other options or those options may generate more anxiety.
Option A: Approach the client in a consistent manner in all interactions. Enhances feelings of security and provides structure. Exceptions encourage manipulative behavior. When the client is ready and interested, teach client coping skills to help defuse tension and trouble feelings (e.g., anxiety reduction, assertiveness skills).
Option B: Be clear with the client as to the unit/hospital/clinic policies. Give brief concrete reasons for the rules, if asked, and then move on. Institutional policies provide structure and safety.
Option C: Give the client positive attention when behaviors are appropriate and productive. Avoid giving any attention (when possible and not dangerous to self or others) when client’s behaviors are inappropriate. Reinforcing positive behaviors might increase the likelihood of repetition. Ignoring negative behaviors (when feasible) robs the client of even negative attention.