Therapeutic Comm Q 41
A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation?
A. "Everyone diagnosed with OCD needs to control their ritualistic behaviors."
B. "It is important for you to discontinue these ritualistic behaviors."
C. "Why are you asking for help if you won't participate in unit therapy?"
D. "Let's figure out a way for you to attend unit activities and still wash your hands."
Correct Answer: D. “Let’s figure out a way for you to attend unit activities and still wash your hands.”
The most appropriate statement by the nurse is, “Let’s figure out a way for you to attend unit activities and still wash your hands.” This statement reflects the therapeutic communication technique of formulating a plan of action. The nurse attempts to work with the client to develop a plan without damaging the therapeutic relationship or increasing the client’s anxiety.
Option A: Disapproving or denouncing the client’s behavior is nontherapeutic. Disapproval implies that the nurse has a right to pass judgement on the client’s actions. It further implies that the client is expected to please the nurse.
Option B: Advising refers to telling the client what to do; giving an opinion or making decisions for the client is inappropriate. It implies that the client cannot handle life decisions and only the nurse knows what is best for the client.
Option C: Requesting an explanation or asking the client to provide reasons for thoughts, feelings, behaviors or events is nontherapeutic. There is a difference between asking the client to describe what is occurring or has taken place and asking him to explain why. Usually, a “why” question is intimidating.