The mental health team working with a homeless client with chronic schizophrenia establishes the treatment goal of, "Improvement in avolition prior to discharge." Which behavior demonstrates achievement of this goal to the nurse?

A) Advising the client to reschedule until committing to recovery may come across as dismissive and could discourage the client from making positive changes. It’s important to support any intention to improve rather than setting conditions that might lead to feelings of failure or frustration.

B) Supporting the client to list small behavioral changes needed is the best response. This approach empowers the client by encouraging them to take manageable steps toward their goals. Focusing on small changes can enhance the client's confidence and motivation, making the process of leading a healthier lifestyle more achievable.

C) Explaining the specific skills needed to prevent relapse is important, but it may be overwhelming for the client at this stage. The focus should be on fostering a sense of hope and readiness for change rather than diving immediately into complex relapse prevention strategies.

D) Providing teaching on the symptoms of substance use dependence might be relevant, but it may not directly support the client's desire for change. The client is expressing a wish to move forward, so it’s more beneficial to focus on positive actions rather than reiterating the challenges of dependence. Supporting behavioral change aligns better with the client’s expressed intentions.

A) Praising the client for her new behavior can be encouraging and may boost her self-esteem. However, it’s essential to approach this cautiously, as excessive praise might overwhelm her or be perceived as insincere. While positive reinforcement is valuable, it should not be the sole focus of the intervention.

B) Offering her a choice of activities can promote autonomy and encourage engagement, but given her recent shift from despondency to exhibiting energy, it’s crucial to assess her mood and mental state carefully first. Providing choices may be helpful, but it should be accompanied by vigilant monitoring to ensure her safety.

C) Involving her in group therapy could facilitate social interaction and support, but it may not be appropriate immediately. After several days of nonverbal behavior, she may still be vulnerable. Group settings could be overwhelming, and her readiness to participate should be carefully evaluated.

D) Observing her actions continuously is the most critical action at this stage. The change in her behavior—from being despondent and nonverbal to talking and exhibiting energy—can indicate a potential shift toward increased risk for impulsivity or self-harm. Continuous observation allows the nurse to assess her safety and intervene if her behavior escalates, ensuring she is supported during this transitional phase.