A nurse in a community health facility is interviewing a client who recently lost his job. The client states. "I was fired because my boss doesn't like me." Which of the following defense mechanisms is the client displaying?

Displacement

Rationalization

Dissociation

Repression

Answer and Explanation

The Correct Answer is B

A. Displacement:
Displacement is a defense mechanism where a person redirects their feelings, often negative or hostile ones, from the original source or target to a different, less threatening target. For example, if the client were to express anger at their boss by yelling at their family members instead, it would be an example of displacement.
B. Rationalization:

Rationalization is a defense mechanism in which a person provides logical or reasonable explanations to justify or explain a situation or behavior, even if these explanations are not entirely true or valid. It involves creating justifications or excuses to make an event or one's actions appear more reasonable or acceptable. In this case, the client is rationalizing the job loss by attributing it to their boss not liking them, which may be an oversimplified or inaccurate explanation.
C. Dissociation:

Dissociation is a defense mechanism where a person mentally separates themselves from their own thoughts, feelings, or experiences to cope with overwhelming or traumatic situations. It involves a disconnection from reality. The client's statement doesn't suggest dissociation; rather, they are providing a reason for their job loss.

D. Repression:
Repression is a defense mechanism that involves the unconscious exclusion of painful or anxiety-provoking thoughts, feelings, or memories from awareness. It is not readily visible or expressed in behavior. The client's statement involves a conscious attempt to explain their job loss, so it's not an example of repression.

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Correct Answer is A

Explanation

A. Encourage participants to express conflicts and work toward resolution:
Explanation: During the working phase of therapy, the nurse encourages participants to express their conflicts, fears, and concerns openly. The working phase is characterized by active participation and problem-solving. Encouraging clients to express their feelings and conflicts helps them work through their issues and promotes resolution. It's a crucial step in the therapeutic process, allowing clients to explore their emotions and gain insight into their anxieties.

B. Inform participants about principles for listening to and respecting each other:
Explanation: Setting ground rules for respectful communication is typically done in the initial or pre-working phase of therapy. While maintaining a respectful environment is important throughout the therapeutic process, it's not specific to the working phase.

C. Suggest that participants reflect on their progress as individuals and as a group:
Explanation: Reflection and assessment of progress can occur throughout therapy, not just in the working phase. It's essential for clients to evaluate their progress, but this action is not exclusive to the working phase.

D. Ask participants to become acquainted with and talk to each other:
Explanation: Building rapport and getting acquainted with other group members often occurs in the initial phase of therapy. During the working phase, the focus shifts more toward discussing and resolving specific issues and conflicts rather than introductory activities.

A. Reassure staff members that the debriefing is confidential. B. Have staff members discuss their involvement in the event. C. Ask staff members to describe their most traumatic memories of the event. D. Provide stress-management exercises to the staff members.

Correct Answer is A

Explanation

A. Reassure staff members that the debriefing is confidential:
Explanation: This step is crucial in establishing trust among the participants. Reassuring confidentiality encourages individuals to express their feelings and experiences openly. It helps create a safe environment where people can share their emotions without fear of judgment or repercussions.

B. Have staff members discuss their involvement in the event:
Explanation: After establishing confidentiality, it might be appropriate to encourage participants to discuss their involvement in the event. This allows individuals to share their perspectives and experiences, helping others understand the situation from different angles. Sharing experiences can provide insights into how different people were affected and how they coped.

C. Ask staff members to describe their most traumatic memories of the event:
Explanation: While it might be a natural inclination to immediately delve into the most traumatic memories, it's generally not the first step in a critical incident stress debriefing. Encouraging participants to share their most traumatic memories right away could be overwhelming and retraumatizing. The process usually begins with establishing trust and then progresses to discussing individual experiences, gradually leading to more specific and potentially distressing details.

D. Provide stress-management exercises to the staff members:
Explanation: Stress-management exercises are valuable and often an essential part of the debriefing process. However, introducing stress-management techniques usually comes after participants have had the opportunity to express their feelings and experiences. These exercises can include relaxation techniques, breathing exercises, or mindfulness practices, which help individuals manage their stress and anxiety effectively.

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