An adolescent hospitalized after a physical outburst tells the nurse, "I’m going to kill my father, but you can’t tell anyone." Select the nurse’s best response.

Choice A reason: Administering medications addresses symptoms pharmacologically but is not a core cognitive behavioral therapy (CBT) intervention. CBT focuses on modifying thoughts and behaviors, not drug therapy, making this choice incorrect for the specified theoretical approach.

Choice B reason: CBT targets negative thought patterns to modify maladaptive behaviors and emotions, central to treating anxiety. Challenging distorted cognitions helps the patient reframe perceptions, reducing withdrawal, aligning with CBT principles, making this the correct choice.

Choice C reason: Group therapy encourages social interaction but is not a primary CBT intervention. CBT focuses on individual cognitive restructuring, not group dynamics, making this choice less relevant for the specified theoretical approach to anxiety treatment.

Choice D reason: Relaxation techniques are adjunctive in CBT but not the primary focus. Challenging negative thoughts is the core intervention, directly addressing cognitive distortions driving anxiety, making relaxation a secondary approach and this choice incorrect.

Choice A reason: Including the child in group activities promotes socialization but is not operant conditioning, which uses rewards to reinforce specific behaviors like speech. This approach lacks direct reinforcement, making it ineffective for the targeted behavior, thus incorrect.

Choice B reason: Observing others talking may model behavior but is not operant conditioning, which requires direct reinforcement of the desired action (speech). Passive observation does not provide the reward structure needed to encourage speech, making this choice incorrect.

Choice C reason: Operant conditioning uses positive reinforcement, like giving a treat for speaking, to increase the desired behavior. This directly rewards the child’s speech, aligning with behavioral psychology principles to encourage verbalization, making this the correct choice.

Choice D reason: Relaxation techniques address anxiety but are not operant conditioning, which focuses on reinforcing specific behaviors with rewards. They do not directly encourage speech, making this choice incorrect for the behavioral approach specified in the treatment plan.