A nurse is reinforcing discharge teaching with a client who has borderline personality disorder. The client reports being a single parent caring for two toddlers. Which of the following actions should the nurse take?

A. Dialectical behavior therapy. Dialectical behavior therapy is primarily used for borderline personality disorder, focusing on emotional regulation, distress tolerance, and mindfulness. It is not the primary therapy for avoidant personality disorder.
B. Antipsychotic medications. Antipsychotic medications are typically used to manage symptoms of psychotic disorders such as schizophrenia. Avoidant personality disorder does not involve psychosis and is better managed with psychotherapy.
C. Interpersonal therapy. Interpersonal therapy is beneficial for avoidant personality disorder as it focuses on improving social skills, self-esteem, and communication. This therapy helps clients develop healthier relationships and overcome fears of rejection.
D. Antidepressant medications. While antidepressants may be used to treat co-occurring conditions such as depression or anxiety, they do not directly address the core features of avoidant personality disorder. Psychotherapy remains the primary treatment.

A. "When attending dialectical behavior therapy." Dialectical behavior therapy (DBT) is specifically designed to help individuals with borderline personality disorder (BPD) manage emotions and reduce self-harming behaviors. While therapy can bring up distressing emotions, it provides structured support and coping strategies. The risk of self-harm is lower when clients are actively engaged in treatment and receiving professional guidance.
B. "When getting married." Major life changes, including marriage, can be stressful for individuals with BPD, but they do not inherently pose the highest risk for self-harm. Support from a partner and structured therapy can help navigate emotional challenges. While instability in relationships can trigger distress, the protective factors of marriage may reduce immediate risk. Self-harm risk is typically higher in periods of transition without support.
C. "When discharged from the hospital." Clients with BPD often struggle with emotional regulation, and discharge represents a significant transition with decreased support. The sudden loss of a structured inpatient setting can increase feelings of abandonment and distress, leading to a heightened risk of self-harm. Ensuring a follow-up care plan and support system is crucial to reducing this risk after hospitalization.
D. "When attending narrative therapy." Narrative therapy helps clients reframe their experiences and build a stronger sense of identity. Although deep emotional topics may be explored, structured therapy provides a safe space for expression. Therapeutic interventions aim to reduce distress and teach coping mechanisms, decreasing the likelihood of self-harm. The highest risk occurs when structured support is suddenly removed.