Psychiatric Assessment and Fundamentals Q 13

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Which of the following approaches would be most appropriate to use with a client suffering from narcissistic personality disorder when discrepancies exist between what the client states and what actually exists?

  

     A. Rationalization

     B. Supportive confrontation

     C. Limit setting

     D. Consistency

    

    

Correct Answer: B. Supportive confrontation

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The nurse would specifically use supportive confrontation with the client to point out discrepancies between what the client states and what actually exists to increase responsibility for himself. Supportive confrontation means that we are putting good energy and effort into addressing a value or principle that seems disconnected or out of alignment, using some specific skills. Over time we view this as an opportunity to deepen relationships, strengthen teams, and enhance our organizations.

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Option A: Rationalization is an attempt to logically justify immoral, deviant, or generally unacceptable behavior. In Freud’s classical psychoanalytic theory, rationalization is a defense mechanism, an unconscious attempt to avoid addressing the underlying reasons for behavior.

Option C: Limit setting allows the boundaries of the therapeutic relationship to be established and provides the consumer with a clear understanding of what is and isn’t acceptable behavior and what the consequences of their actions will be.

Option D: Consistency refers to the way in which minority influence is more likely to occur if the minority members share the same belief and retain it over time. This then draws the attention of the majority to the minority.

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