Chapter 34: Therapeutic Groups |Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

MULTIPLE CHOICE 1. A patient tells members of a therapy group, ―I hear voices saying my doctor is poisoning me.‖ Another patient replies, ―I once heard voices too. They sounded real, but I found out later they were not. The voices you hear are not real either.‖ Which therapeutic factor is exemplified in this interchange? a. Catharsis b. Universality c. Imitative behavior d. Interpersonal learning ANS: D Here a member gains insight into his own experiences from hearing about the experiences of others through interpersonal learning. Catharsis refers to a therapeutic discharge of emotions. Universality refers to members realizing their feelings are common to most people and not abnormal. Imitative behavior involves copying or borrowing the adaptive behavior of others. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 34-32 (Box 34-2) | Page 34-18 (Table 34-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 2. A leader plans to start a new self-esteem building group. Which intervention would be most helpful for assuring mutual respect within the group? a. Describe the importance of mutual respect in the first session and establish it as a group norm. b. Exclude potential members whose behavior suggests they are likely to be disrespectful of others. c. Give members a brochure describing the purpose, norms, and expectations of the group. d. Explain that mutual respect is expected and confront those who are not respectful. ANS: A It is helpful to motivate members to behave respectfully by describing how mutual respect benefits all members and is necessary for the group to be fully therapeutic. Setting a tone and expectation of mutual respect from the outset is the most helpful intervention listed. Excluding members because of how they might behave could exclude members who would have been appropriate, depriving them of the potential benefits of the group. Conveying expectations by brochure is less effective than doing so orally, because it lacks the connection to each member a skilled leader can create to motivate members and impart the expectation of respect. Confronting inappropriate behavior is therapeutic but only addresses existing behavior rather than preventing all such undesired behavior. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 34-5, 9 TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity 3. A young female member in a therapy group says to an older female member, ―You are just like my mother, always trying to control me with your observations and suggestions.‖ Which therapeutic factor of a group is evident by this behavior? a. Instillation of hope b. Existential resolution c. Development of socializing techniques d. Corrective recapitulation of the primary family group ANS: D The younger patient is demonstrating an emotional attachment to the older patient that mirrors patterns within her own family of origin, a phenomenon called corrective recapitulation of the primary family group. Feedback from the group then helps the member gain insight about this behavior and leads to more effective ways of relating to her family members. Instillation of hope involves conveying optimism and sharing progress. Existential resolution refers to the realization that certain existential experiences such as death are part of life, aiding the adjustment to such realities. Development of socializing techniques involves gaining social skills through the group‘s feedback and practice within the group. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 34-18 (Table 34-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 4. During group therapy, one patient says to another, ―When I first started in this group, you were unable to make a decision, but now you can. You‘ve made so much progress that I am beginning to think maybe I can conquer my fears too.‖ Which therapeutic factor is evident by this statement? a. Hope b. Altruism c. Catharsis d. Cohesiveness