A nurse is planning care for a group of clients on a mental health unit. Which of the following actions should the nurse plan to take to create a therapeutic environment?

Choice A Reason:
Assessing the client's readiness for therapy is a crucial role of the nurse in CBT. It involves determining whether the client is willing and able to participate in therapy, understands the CBT process, and is motivated to engage in the cognitive and behavioral changes that CBT requires. This assessment helps ensure that the therapy is client-centered and tailored to the individual's specific needs and readiness level.

Choice B Reason:
While involving the client's family can be beneficial in therapy, implementing therapeutic techniques that involve only the client's family does not align with the primary goals of CBT. CBT focuses on the individual's patterns of thinking and behavior, and while family support can be part of the process, the nurse's role is not limited to family involvement alone.

Choice C Reason:
Educating the client to identify and challenge negative thoughts is a fundamental aspect of CBT. The nurse helps the client recognize their automatic negative thoughts, understand the impact these thoughts have on their emotions and behavior, and learn to challenge and reframe these thoughts in a more positive and realistic way.

Choice D Reason:
Evaluating to determine the effectiveness of the actions is part of the nurse's role in CBT. This involves monitoring the client's progress, assessing the outcomes of the interventions, and making necessary adjustments to the treatment plan. Evaluation is an ongoing process that ensures the therapy is effective and meets the client's needs.

Choice E Reason:
Collaborating with the client to set achievable goals is essential in CBT. The nurse works with the client to establish clear, measurable, and attainable goals that guide the therapy process. These goals provide direction and motivation, and they help the client focus on making specific changes that will improve their mental health.

Choice A reason:
Conversion is a defense mechanism where emotional distress is expressed through physical symptoms. This does not apply to the student's behavior, which is verbally directed towards the teacher and the course rather than manifesting as physical symptoms.

Choice B reason:
Regression involves reverting to behaviors typical of an earlier developmental stage when faced with stress. The student's behavior does not indicate a regression to childlike behaviors but rather an outward projection of feelings onto the teacher and course.
Choice C reason:
Projection is a defense mechanism where an individual attributes their own unacceptable thoughts, feelings, or motives to another person. In this case, the student is projecting their feelings of failure and frustration onto the teacher and course, blaming them for the negative outcome.

Choice D reason:
Undoing is a defense mechanism where a person tries to 'undo' an unhealthy, destructive, or otherwise threatening thought or action by engaging in contrary behavior. The student's action of berating does not attempt to undo the failure but instead shifts responsibility away from themselves.