A homeless individual diagnosed with serious mental illness, anosognosia, and a history of persistent treatment nonadherence is persuaded to come to the day program at a community mental health center
Which intervention should be the team's initial focus?
a. Teach appropriate health maintenance and prevention practices.
b. Educate the patient about the importance of treatment adherence.
c. Help the patient obtain employment in a local sheltered workshop.
d. Interact regularly and supportively without trying to change the patient.
ANS: D
Given the history of treatment nonadherence and the difficulty achieving other goals until psychiatrically stable and adherent, getting the patient to accept and adhere to treatment is the fundamental goal to address. The intervention most likely to help meet that goal at this stage is developing a trusting relationship with the patient. Interacting regularly, supportively, and without demands is likely to build the necessary trust and relationships that will be the foundation for all other interventions later on. No data here suggest the patient is in crisis, so it is possible to proceed slowly and build this foundation of trust.
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