A client, aged 15 years, has been referred to the mental health center by the juvenile court after being arrested for prostitution. Her parents told the court they could not manage her, that she was physically abusive to her mother and defiant and hostile to her father. At the mental health center she refused to participate in scheduled activities. She also pushed an elderly client, causing her to fall. The approach by nursing staff that would be most therapeutic is
a. neutrally permitting refusals.
b. coaxing to gain compliance.
c. offering rewards in advance.
d. establishing firm limits.
D
Firm limits are necessary to ensure physical safety and emotional security. Limit setting will also
protect other clients from the teen's thoughtless or aggressive behavior. Permitting refusals to
participate in the treatment plan, coaxing, and bargaining are strategies that do not help the client
learn to abide by rules or structure.
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