A client who grew up with alcoholic parents is reluctant to discuss thoughts, feelings, and self-defeating behaviors with the nurse. Which of the following responses by the nurse would be most helpful?
1. "We don't have to talk about your feelings if you don't want to. Let's discuss the behaviors you would like to change."
2. "Some clients who were raised in alcoholic families are reluctant to discuss their feelings. How has this impacted you?"
3. "I understand that you are not used to discussing your feelings; however, we can't continue unless you open up to me."
4. "I understand that opening up to others is difficult for you, but you need to change your view about discussing family issues with me."
2
Rationale: Acknowledging the client's reluctance and asking the client to comment on this issue will encourage a dialogue that could lead to the development of further insights. Changing the subject and allowing the client to remain silent about feelings could create a pattern for continued avoidance of feelings. Demanding a change in the client's views or threatening to discontinue the relationship could inhibit the development of a therapeutic alliance.
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