A client receiving cognitive behavior therapy (CBT) is introduced to the concepts guiding the therapy. Which statement best explains automatic thoughts?

A. Sharing personal information with a client is a boundary violation, as it blurs the professional relationship and creates a risk for the client to become involved in the nurse's personal issues.

B. Making plans to have lunch with a client after discharge is also a boundary violation, as it can be interpreted as crossing the professional boundary and compromising the nurse's objectivity and impartiality.

C. Agreeing to keep a secret from a client can also be a boundary violation, as it may interfere with the nurse's professional judgment and duty to protect the client's safety and well-being.

D. Allowing a client to hold the nurse's hand before chemotherapy is not necessarily a boundary violation, as this can be a form of emotional support that is appropriate in some circumstances.

E. Reading a 'get-well' card to a client is not a boundary violation, as it is a form of emotional support that is appropriate and professional.

The technique described, where a client is placed in a situation that elicits high levels of anxiety or fear and is exposed to the feared stimuli in a safe and controlled environment, is known as flooding. In this case, the client with a fear of spiders is exposed to many spiders at once, which is an overwhelming and anxiety-provoking experience. However, the client is also aware that they are in a safe and controlled environment and can escape if necessary. Over time, this exposure should lead to a reduction in anxiety and fear.

Positive reinforcement involves rewarding desired behaviors to increase their likelihood of occurring in the future, while modeling involves learning by observing and imitating others' behaviors. Systematic desensitization involves gradually exposing a client to a feared stimulus while teaching relaxation techniques to reduce anxiety and fear.