ANSWER
Scenario Description for an Argumentative Client: Utilising Course Knowledge
Setting: A clinic for outpatient mental health. The interaction takes place at a planned follow-up for drug management.
Type of Encounter: The client, a 30-year-old woman, has been diagnosed with depression and generalised anxiety disorder (GAD). She refuses to use prescription drugs, saying they make her dependent, and she prefers natural solutions.
Challenging Customer Conduct
Defensiveness: When the NP brings up her lack of progress, the client gets combative and keeps interrupting to refute the NP’s suggestions.
Scepticism: She casts doubt on the need for medicine and references unreliable internet sites or anecdotal data to support her assertion that nutrition alone may treat depression and anxiety.
Non-adherence: The client acknowledges that she stopped taking her prescription SSRI (sertraline) without talking to the NP because she was afraid of addiction and its negative effects, but she won’t try other drugs.
Emotional Outbursts: She starts crying and accuses the NP of not respecting her independence, which makes the situation stressful.
Customer Behavior’s Effect on the Client-Provider Relationship
Stress on Trust: The NP may find it more difficult to lead the client towards successful treatment if her defensiveness and scepticism undermine rapport and trust.
Limited Collaboration: Shared decision-making is hampered by the client’s noncompliance and unwillingness to take alternatives into account.
Emotional Fatigue: The NP’s capacity to maintain empathy and patient-centered care may be hampered by feelings of frustration or helplessness.
Suboptimal Results: The client’s mental health may worsen in the absence of a predetermined goal, which would make the therapeutic alliance even more difficult.
Methods for Improving Communication
Listening Actively:
Show respect and understanding by listening to the client’s concerns in their entirety before answering.
For instance: “I’ve heard you’re concerned about side effects and reliance. Together, let’s examine those issues.
Validation & Empathy:
To lessen defensiveness, acknowledge her emotions without passing judgement.
For instance: “It’s quite normal to be wary of taking medicine. Many folks have similar concerns.
Psychoeducation
Give her accurate, fact-based information about her illness and how drugs can help with symptom management.
For instance, use analogies such as equating prescription drugs with spectacles that aid in vision correction but do not take the place of counselling and lifestyle modifications.
Motivational Interviewing:
Urge the client to consider her objectives and how her present strategy fits with them.
For instance: “How would you like your anxiety and despair to change? How do you think your present strategy is assisting you in reaching those objectives?
Setting Goals Together:
Engage the client in developing a treatment plan that takes into account her preferences, such as combining evidence-based practices with lifestyle modifications or herbal remedies.
As an illustration, that a low-dose SSRI be tried with consistent therapy sessions and side effect monitoring.
Examples of Documentation
Subjective:
The client shows up for a follow-up on depression and GAD. reports stopping the sertraline they were prescribed four weeks ago because they were worried about adverse effects and dependency. She acknowledges that she has ongoing anxiety and depression but says she would rather control her symptoms with food and exercise. reports having trouble focusing and falling asleep, but denies having suicidal thoughts.
Goal:
Affect: During the encounter, I felt both furious and tearful.
Speech: NP was clear but occasionally interrupted to question suggestions.
Moderate-to-severe depression, PHQ-9 score: 17. 15 on the GAD-7 indicates severe anxiety.
Evaluation:
medication non-adherence in patients with generalised anxiety disorder (GAD).
Moderately severe, untreated major depressive disorder (MDD).
Plan:
Motivational interviewing was used to discuss potential advantages and concerns with medication with the client.
gave psychoeducation on how SSRIs can be used to treat neurotransmitter abnormalities.
provided a low-dose SSRI substitute along with a planned 4-week follow-up schedule to track effectiveness and adverse effects.
offered information on mindfulness-based stress reduction (MBSR) and encouraged the continuance of routine therapy sessions.
agreed to reevaluate treatment choices and monitor progress in four weeks.
supplied informational resources about research-backed therapies for depression and anxiety.
Follow-up: The client should come back for another evaluation in four weeks, or earlier if their symptoms get worse.
Academic Source
By emphasising the client’s autonomy and innate drive for change, motivational interviewing effectively addresses client resistance and promotes shared decision-making, especially in mental health care (Miller & Rollnick, 2013).
Citation
Rollnick, S., and W. R. Miller (2013). Helping people change through motivational interviewing (3rd ed.). The Guilford Press.
QUESTION
Argumentative Client
- Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
- Create a scenario depicting an interaction between an NP and a client. Describe the setting and type of encounter.
- Describe the client’s challenging behaviors related to the topic assigned.
- Examine the potential impact of the client’s behavior on the client-provider relationship.
- Analyze techniques to enhance communication with the client and address the client’s behavior.
- Create sample documentation for the encounter.
- Integration of Evidence: Integrate relevant scholarly sources as defined by program expectations.
- Cite a scholarly source in the initial post.