A client is readmited to the substance use disorder program for the second time in 6 months for alcohol use disorder. Upon admission, the client tells the nurse, "I am so ashamed." What should the nurse reply?

Choice A reason: Stopping the client from performing rituals can increase anxiety and distress. Rituals are a coping mechanism for individuals with OCD, and abruptly preventing them can lead to a significant increase in anxiety.

Choice B reason: Allowing the client to perform rituals can provide a sense of security and control, which is important for individuals with OCD. Over time, with appropriate therapy, the need for these rituals can be reduced.

Choice C reason: While encouraging the client to talk about the purpose of the rituals can be part of cognitive-behavioral therapy, it may not immediately increase the client's sense of security. This approach is more about understanding and eventually managing the compulsions.

Choice D reason: Distracting the client from rituals with other activities can be a helpful strategy in therapy but may not directly increase the client's sense of security. It can be used as a part of a comprehensive treatment plan to gradually reduce the reliance on rituals.

Choice A reason: This is the correct choice. Consistent enforcement of rules prevents manipulation and maintains a stable environment for all clients.
Choice B reason: While encouraging questions and discussion is generally positive, it does not directly address manipulative behavior.
Choice C reason: Promoting social ostracism is not therapeutic and can harm the client's mental health and recovery.
Choice D reason: Scheduling one-on-one time could be beneficial, but it does not address the issue of manipulation towards the staff.