Question

An extremely agitated client is brought to the psychiatric unit by her husband. He reports that she has been hospitalized several times for treatment of bipolar disorder and has spent thousands of dollars in the past week. The psychiatrist admits her to the unit for exacerbation of the manic phase of bipolar disorder. Which approach by the nurse would best promote a therapeutic relationship with this client?

1. Confronting the client about her inappropriate behavior
2. Using reflection and open-ended questions to promote communication
3. Maintaining a firm but nonthreatening manner
4. Helping the client gain insight into her behavior

Answer 1

The best approach for a nurse to promote a therapeutic relationship with a client in the manic phase of bipolar disorder is to maintain a firm but nonthreatening manner, and to use reflection and open-ended questions to encourage communication.

Step-by-step explanation:

The approach that would best promote a therapeutic relationship with a client exhibiting manic behavior due to bipolar disorder is maintaining a firm but nonthreatening manner. This approach facilitates a safe environment allowing for open communication without escalating the client's agitation. Using reflection and open-ended questions to promote communication also helps by engaging the client in a way that encourages them to express their feelings and thoughts without feeling judged or confronted. While helping the client gain insight into her behavior is an ultimate goal, it's more appropriate once the acute phase has stabilized and when the client is more receptive. Confronting the client about inappropriate behavior can be counterproductive during an acute manic phase, as it may increase agitation and resistance to treatment.