Substance Abuse and Abuse Q 58
The nurse is planning care for a client who has a phobic disorder manifested by a fear of elevators. Which goal would need to be accomplished first?
A. The client will demonstrate the relaxation response when asked.
B. The client will verbalize the underlying cause of the disorder.
C. The client will ride the elevator in the company of the nurse.
D. The client will roleplay the use of an elevator.
Correct Answer: A. The client will demonstrate the relaxation response when asked.
The ability to use relaxation is basic to treatment of phobia. Support the patient in recognizing strategies used in the past to deal with fearful situations. This method allows the patient to think that fear is a natural part of life and can be dealt with successfully. Initiate alternative treatments. Provide verbal and nonverbal (touch and hug with permission) reassurances of safety if safety is within control. Meditation, prayer, music, therapeutic touch, and healing touch techniques help lighten fear.
Option B: Clients with phobias are resistant to insight therapy. Insight Therapy is a type of psychotherapy in which the therapist helps their patient understand how their feelings, beliefs, actions, and events from the past are influencing their current mindset. Importance is placed on the relationship between the therapist and the patient with the therapist identifying behavioral patterns from the patient’s past that could be affecting their behavior and relationships at the present time.
Option C: Riding the elevator accompanied by the nurse is an appropriate long-term goal. As the fear subsides, encourage the patient to involve himself or herself to specific events preceding the onset of the fear. Recognition and explanation of factors leading to fear are vital in developing alternative responses.
Option D: Role-playing may be appropriate after the client has learned relaxation. Expose the client to a predetermined list of anxiety-provoking stimuli rated in hierarchy from the least frightening to the most frightening. Experiencing fear in progressively more challenging but attainable steps allows the client to realize that dangerous consequences will not occur. Helps extinguish conditioned avoidance response.