The patient tells his primary nurse "I get into trouble because I have hair-trigger responses. I shoot from the hip. Lots of times that gets me into a mess.". Which response would be most therapeutic?
a. "Let's look at ways to help you slow it down and think before acting.".
b. "It might help to explore how you came to be that way–any ideas?"
c. "I'll bet you have some interesting stories to share about overreacting.".
d. "It's good that you're showing readiness and motivation to change.".
A
Interventions exist to slow reactivity to at least some forms of provocation for the patient. Educating the patient about these techniques provides other coping options when faced with those same provocations in the future. Although exploring factors that contributed to the patient's current behavioral patterns can be helpful, there are effective strategies the patient can use to change behavior that are not dependent on knowing the origins of the behavior (which many times are unknown to the patient). Asking the patient about stories serves no therapeutic purpose, and maladaptive behavior can be reinforced by showing interest in them. Insight is not necessarily indicative of readiness or motivation to change.
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