Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?

Choice A reason: Sullivan’s interpersonal theory emphasizes therapeutic relationships and social environments to foster mental health. The therapeutic milieu, structured to promote safety and interaction, aligns with Sullivan’s focus on interpersonal dynamics, reducing symptoms like anxiety through supportive settings, which stabilize neurotransmitter imbalances, enhancing patient recovery on psychiatric units.

Choice B reason: Sullivan’s theory does not focus on age-appropriate versus arrested behaviors. It emphasizes interpersonal relationships, not developmental stages. Assessment tools for behavior typically rely on other frameworks, like Erikson’s, which address developmental milestones, not Sullivan’s interpersonal model, making this option scientifically inaccurate for the theory’s application.

Choice C reason: Restraint and seclusion are not part of Sullivan’s theory, which promotes therapeutic relationships to reduce anxiety, not coercive measures. These interventions contradict Sullivan’s focus on supportive environments, as they may exacerbate stress and neurotransmitter dysregulation, such as increased cortisol, worsening mental health outcomes in psychiatric settings.

Choice D reason: The nursing process is a general framework, not specific to Sullivan’s theory. Sullivan’s interpersonal model focuses on relationships to alleviate symptoms, not on sequencing nursing actions. While the nursing process guides care, it is not derived from Sullivan’s principles, making this option unrelated to his theoretical application.

Choice A reason: Discussing ego states is rooted in transactional analysis, not cognitive therapy. Ego states involve conscious and unconscious personality aspects, unrelated to addressing cognitive distortions like negative self-perception in inadequacy. Cognitive therapy targets thought patterns, not personality structures, making this approach scientifically irrelevant for the described intervention.

Choice B reason: Cognitive therapy focuses on identifying and modifying distorted thoughts, such as irrational beliefs about inadequacy, which are linked to altered serotonin and dopamine signaling in depression. By restructuring these thoughts, the therapy improves emotional regulation and behavior, aligning with evidence-based treatment for addressing feelings of inadequacy.

Choice C reason: Negative reinforcement is a behavioral therapy technique, not cognitive therapy. It involves removing aversive stimuli to increase desired behaviors, unrelated to addressing cognitive distortions like self-blame. Cognitive therapy targets thought patterns, not behavioral conditioning, making this approach scientifically inappropriate for the described therapeutic context.

Choice D reason: Focusing on unconscious processes is psychoanalytic, not cognitive, therapy. Inadequacy feelings stem from conscious cognitive distortions, not unconscious conflicts. Cognitive therapy corrects faulty thinking linked to neurotransmitter imbalances, not repressed memories, making this option misaligned with the scientific basis of the therapy described.