A nurse is admitting a client to an alcohol abuse program. The client states, "I'm here because of my boss.
It was part of my job to go to parties and drink with clients." The client's statement is an example of which of the following defense mechanisms?
Suppression.
Rationalization.
Reaction-formation.
Compensation.
The Correct Answer is B
Choice A rationale:
Suppression involves the conscious, intentional effort to push unwanted thoughts, feelings, or memories out of awareness. It is not evident in the client's statement, as they are not actively trying to forget or avoid their alcohol use. Instead, they are attempting to justify it.
Choice B Rationale:
Rationalization is the defense mechanism most clearly demonstrated in the client's statement. It involves creating false but seemingly logical reasons to justify unacceptable behavior or feelings. The client is attributing their alcohol use to external factors (their boss and job requirements) rather than taking responsibility for their own choices and actions. This allows them to avoid confronting the reality of their addiction and the need for change.
Key characteristics of rationalization that align with the client's statement:
Externalizing blame: The client places responsibility for their drinking on their boss and job, rather than acknowledging their own agency.
Minimizing the problem: The client suggests that their drinking was merely a necessary part of their job, downplaying the extent of their alcohol use and its negative consequences.
Avoiding negative emotions: By shifting blame, the client protects themselves from feelings of guilt, shame, and responsibility associated with their addiction.
Choice C Rationale:
Reaction formation involves behaving in a way that is opposite to one's true feelings or impulses. This is not evident in the client's statement, as they are not expressing overly negative or critical attitudes towards alcohol. Instead, they are attempting to justify their use of it.
Choice D Rationale:
Compensation involves overemphasizing a desirable trait or behavior to make up for a perceived weakness or deficiency. This is not evident in the client's statement, as they are not highlighting any positive qualities or accomplishments to offset their alcohol use.
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Related Questions
Correct Answer is A
Explanation
Choice A rationale:
1. Understanding OCD:
OCD is a chronic mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
Individuals with OCD feel compelled to perform rituals to relieve anxiety or prevent perceived harm, even if they recognize the behaviors as excessive or irrational.
Rituals can consume significant time and interfere with daily functioning.
2. Rationale for Choice A:
Acknowledges the client's needs: Planning for rituals demonstrates understanding and acceptance of the client's experience, fostering trust and rapport.
Reduces anxiety: Allowing time for rituals can temporarily reduce anxiety, making the client more receptive to other interventions.
Gradual approach: It's a stepping stone towards Exposure and Response Prevention (ERP), the gold-standard treatment for OCD.
Enhances control: Scheduling rituals can help the client feel more in control, reducing the urge to engage in them compulsively.
3. Addressing potential concerns:
Reinforcing rituals: While there's a possibility of temporarily reinforcing rituals, it's a necessary first step to build trust and engagement in therapy.
Interfering with treatment: Scheduling rituals is a part of a comprehensive treatment plan that includes ERP and other therapies to address the underlying causes of OCD.
4. Importance of individualized care:
The specific approach to planning for rituals should be tailored to the client's unique needs, preferences, and severity of symptoms.
Collaboration with the client is essential to ensure their active participation in treatment. I'll now address the rationales for the incorrect choices:
Choice B rationale:
Setting strict limits on behaviors can be counterproductive: Triggers anxiety and distress
Impedes trust and therapeutic alliance Diminishes sense of control
Heightens resistance to treatment
Choice C rationale:
Confronting the client about the senselessness of rituals is ineffective and potentially harmful: Exacerbates anxiety and shame
Alienates the client
Disregards the involuntary nature of OCD Undermines motivation for treatment Choice D rationale:
Isolating the client is unethical and detrimental:
Increases distress and loneliness Impedes therapeutic interactions Reinforces negative self-perceptions
Lacks evidence of efficacy in OCD treatment
Correct Answer is B
Explanation
Choice A rationale:
This response is dismissive and judgmental. It implies that the client's partner was wrong to share the news, and it does not acknowledge the client's feelings. This could make the client feel even more isolated and unsupported.
It's important to remember that the client is likely experiencing a range of emotions, including shock, sadness, anger, and anxiety. The nurse's role is to provide support and validation, not to judge the client's feelings or the actions of their partner.
Choice B rationale:
This response demonstrates empathy and understanding. It acknowledges the client's feelings and invites them to share more about their experience. This can help the client to feel heard and supported.
By verbalizing the client's feelings, the nurse is helping them to process the news and begin to cope with the situation. This can be a valuable first step in helping the client to develop a plan for moving forward.
Choice C rationale:
This response is dismissive and unhelpful. It does not acknowledge the client's feelings, and it offers no support or guidance. This could make the client feel even more hopeless and helpless.
While it may be true that there is not much the client can do about the situation immediately, the nurse can still offer support and help the client to explore their options.
Choice D rationale:
This response is premature and potentially unrealistic. The client may not be ready to contact their boss yet, and there is no guarantee that their job will be available to them. This could set the client up for disappointment and further distress.
It's important to allow the client to process the news and consider their options before taking any action. The nurse can help the client to identify potential resources and supports, and to develop a plan that is right for them.
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