A client's progress notes read, "states he does not want to sit or talk with others; they ‘frighten' him; stays in room alone unless strongly encouraged to come out; no group involvement; at times listens to group from a distance but does
not engage in conversation; some hypervigilance and scanning noted." The nurse decides that the client's behavior is defensive and plans care accordingly. Which strategy should the nurse employ? 1. Help the client gradually accept realistic goals.
2. Help the client identify his fears regarding participating in the group.
3. Help the client develop motivation and a plan for group involvement.
4. Help the client see that there is a possibility for change.
2
Rationale: This client appears to be using projection. Identifying his fears would help the client understand he is attributing to others hostile motives that do not actually exist. Helping the client accept realistic goals would benefit a client who uses fantasy as a coping defense. Helping the client see possibility for change benefits a client who copes by rationalization. Helping the client develop a plan would benefit a client who uses intellectualization to cope with anxiety.
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