Personality and Mood Disorders Q 56
When working with the nurse during the orientation phase of the relationship, a client with a borderline personality disorder would probably have the most difficulty in:
A. Controlling anxiety.
B. Terminating the session on time.
C. Accepting the psychiatric diagnosis.
D. Setting mutual goals for the relationship.
Correct Answer: D. Setting mutual goals for the relationship.
Clients with borderline personality disorders frequently demonstrate a pattern of unstable interpersonal relationships, impulsiveness, affective instability, and frantic efforts to avoid abandonment; these behaviors usually create great difficulty in establishing mutual goals. Set goals realistically, and renegotiate goals frequently. Remember that a client’s negative self-view and distrust of the world took years to develop.
Option A: Teach stress-reduction techniques such as deep breathing relaxation, meditation, and exercise. Clients experience intense anxiety and fear of abandonment. Stress reduction techniques help the client focus more clearly. Be non-judgmental and respectful when listening to client’s feelings, thoughts, or complaints. Clients have an intense fear of rejection.
Option B: Clients with BPD can be manipulative. Consistent limit setting helps provide structure and decrease negative behaviors. Use assertiveness when setting limits on the client’s unreasonable demands for attention and time. Firm, clear, nonjudgmental limits give the client structure.
Option C: Interventions often call for responses to the client’s intense and labile mood swings, irritability, depression, and anxiety. Many of the dysfunctional behaviors of BPD clients (e.g., parasuicidal, anger, manipulation, substance abuse) are used as “behavioral solutions” to intense pain.