Question

An adolescent with borderline personality disorders is hospitalized with suicidal ideation and self-mutilation. Which goal is both therapeutic and realistic for this client? A. The client will remain in her room when feeling overwhelmed by sadness. B. The client will request medication when feeling loss of emotional control. C. The client will leave group activities to pace when feeling anxious. D. The client will seek out a staff member to verbalize feelings of anger and sadness.

Short answer

Answer: The most therapeutic and realistic goal for the client is to seek out a staff member to verbalize feelings of anger and sadness, as it promotes healthy communication, emotional regulation, and support.

Step-by-step solution

Evaluate option A

Consider whether "The client will remain in her room when feeling overwhelmed by sadness" is a therapeutic and realistic goal for the client. This option seems to focus on isolation as a coping mechanism, which may not be the most beneficial approach for someone struggling with suicidal ideation and self-mutilation. It does not promote healthy communication or emotional regulation skills.

Evaluate option B

Consider whether "The client will request medication when feeling loss of emotional control" is a therapeutic and realistic goal for the client. While medication can be helpful in managing some symptoms, relying solely on medication may not address the underlying emotional issues that the client is dealing with. This option does not emphasize the importance of developing coping strategies or interpersonal skills.

Evaluate option C

Consider whether "The client will leave group activities to pace when feeling anxious" is a therapeutic and realistic goal for the client. This option seems to promote avoidance as a coping mechanism. While taking a break from a stressful situation can be useful, it may not be the most effective strategy for managing anxiety in the long term. This option does not address the need for emotional regulation or healthy communication with others.

Evaluate option D

Consider whether "The client will seek out a staff member to verbalize feelings of anger and sadness" is a therapeutic and realistic goal for the client. This option encourages the client to seek support and open communication, which is essential in managing emotions and improving mental health. Additionally, by verbalizing feelings, the client can develop better emotional regulation and interpersonal skills.

Choose the best option

Based on the evaluations of each option, the most therapeutic and realistic goal for the adolescent client with borderline personality disorders, suicidal ideation, and self-mutilation is option D, "The client will seek out a staff member to verbalize feelings of anger and sadness." This option promotes healthy communication, emotional regulation, and support, all of which are critical in managing borderline personality disorders and improving mental health.

Key concepts

Mental Health Nursing

Mental health nursing is a specialized field dedicated to the care of individuals with mental health disorders. Nurses in this field work closely with patients to manage their conditions and improve their quality of life. A significant aspect of mental health nursing is the creation of a safe and therapeutic environment. This includes forming trust-based relationships and providing individualized care that caters to a patient's specific needs, such as those with Borderline Personality Disorder (BPD).

Nurses apply various strategies, such as risk assessment for self-harming behaviors, and work with interdisciplinary teams to devise comprehensive care plans. This involves monitoring the patient's progress, adjusting treatment plans as needed, administering medication, and offering support for patients to develop functional coping mechanisms. The goal of mental health nursing is not only to mitigate symptoms but also to empower patients, as seen in the exercise where the most effective option is encouraging the patient to actively seek out support during emotional distress.

Therapeutic Communication

Therapeutic communication is a cornerstone of mental health nursing that involves the intentional use of dialogue to support healing and well-being. It requires active listening, empathy, and the ability to respond to patients without judgment. Nurses utilize therapeutic communication to build rapport, which allows patients to feel understood and safe to express their emotions.

Techniques such as open-ended questions, reflection, and summarizing are employed to encourage patients to explore their feelings, as represented in the correct option from the exercise where the patient is encouraged to verbalize feelings. This approach helps nurses to identify potential triggers and tailor interventions effectively. It's crucial when dealing with psychiatric disorders because it provides a means for patients to voice their internal experiences, thereby contributing to their emotional regulation and coping strategy development.

Coping Strategies for Psychiatric Disorders

Coping strategies are essential for individuals with psychiatric disorders to manage their symptoms and maintain mental stability. These strategies encompass a wide range of behaviors and thought processes that allow individuals to deal with stressors in a healthy way. In dealing with BPD, effective coping strategies might include mindfulness practices, emotional regulation techniques, and distress tolerance skills.

Healthcare providers collaborate with patients to help them identify both positive and negative coping mechanisms and guide them towards more adaptive methods. For example, in the presented exercise, the patient is encouraged to engage in healthy communication rather than isolating themselves or avoiding challenging situations. Teaching patients practical and constructive coping techniques is a continual process that can significantly improve their resilience and ability to navigate life's challenges.