A nurse is conducting a group therapy session on an inpatient psychiatric unit. A client with a diagnosis of antisocial personality disorder consistently interrupts others, makes sarcastic remarks, and attempts to dominate the conversation. Which action should the nurse take first?
- AAsk the client to leave the group session.
- BRedirect the conversation to another group member.
- CAddress the client's behavior directly and set limits.
- DIgnore the behavior to avoid escalating the situation.
Show answer & explanationAnswer & explanation
Correct answer: C. Address the client's behavior directly and set limits.
In group therapy, it is crucial for the nurse to maintain a therapeutic environment. Antisocial personality disorder often involves disregard for rules and others' rights. Addressing the behavior directly and setting clear limits is essential to protect the group process and ensure the safety and participation of all members. Ignoring the behavior or simply redirecting it can reinforce the client's disruptive pattern.
Why the other options are wrong
- A. Asking the client to leave should be a last resort after attempting to set limits and engage them therapeutically.
- B. While redirecting can be a strategy, in this scenario, the client's consistent and dominating behavior requires direct intervention to set boundaries, not just a redirection.
- D. Ignoring disruptive behavior can reinforce it and send a message to other group members that such behavior is acceptable, undermining the therapeutic environment.
Managing Disruptive Group Behavior
When a client consistently disrupts group therapy, the nurse's primary role is to set clear, firm limits on behavior to protect the therapeutic environment and ensure the safety and participation of all members.
- Establish group rules early.
- Address disruptive behavior directly.
- Protect the group's therapeutic space.
Memory trick: Limits Lead to Lasting Group Growth.