Question

A client with antisocial personality disorder smokes where it's prohibited and refuses to follow other unit and facility rules. The client gets others to do the laundry and other personal chores, splits the staff, and will work only with certain nurses. The care plan for this client should focus primarily on:

1. consistently enforcing unit rules and facility policy.
2. isolating the client to decrease contact with easily manipulated clients.
3. engaging in power struggles with the client to minimize manipulative behavior.
4. using behavior modification to decrease negative behavior by using negative reinforcement.

Answer 1

The care plan for a client with antisocial personality disorder should focus on consistently enforcing unit rules and facility policy, while using behavior modification strategies to reinforce positive behavior.

Step-by-step explanation:

When dealing with a client diagnosed with antisocial personality disorder, the care plan should primarily focus on consistently enforcing unit rules and facility policy to establish clear boundaries and expectations. This includes not tolerating prohibited behaviors such as smoking in non-smoking areas and ensuring the client fulfills personal responsibilities rather than manipulating others to do chores. Rather than isolating the client or engaging in power struggles, which can exacerbate the situation and do not facilitate the development of positive behaviors, it's important to maintain a structured environment and use positive reinforcement techniques as part of behavior modification strategies to encourage desired behaviors.

Such a care plan is in alignment with the strategy of resocialization within total institutions, such as the clinical setting described, where strict adherence to rules helps individuals adapt to the social norms of the environment. An approach that utilizes a combination of firm rule enforcement and behavior modification can lead to a decrease in manipulative and negative behaviors by reinforcing positive behavior changes. This method aligns with research suggesting that a structured environment can be beneficial to both the client and the clinical setting, fostering a safer and more therapeutic atmosphere.