DHS Staff Nurse - 2018 (Shift-2nd)
Mental Health Nursing
Hard
Supportive therapy for a client who is exhibiting manic behaviour may include all of the following except?
Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)
Explanation
- Psychoanalysis is a long-term, insight-oriented therapy focused on exploring unconscious conflicts and past experiences.
- It is contraindicated for clients in an acute manic phase because they lack the stable mood, frustration tolerance, and ability to reflect that this therapy requires.
- The unstructured, introspective nature of psychoanalysis can increase agitation, anxiety, and disorganization in a client experiencing mania.
- Supportive therapy aims to relieve current symptoms without deep exploration of the past, which is the priority in mania management (SRC_13166).
Why Other Options Were Wrong
- Option B: Cognitive therapy is a structured, evidence-based approach that is highly effective as an adjunct treatment for bipolar disorder.
- Option C: Interpersonal therapy, particularly Interpersonal and Social Rhythm Therapy (IPSRT), is specifically designed for bipolar disorder.
- Option D: Problem-solving therapy is a practical, here-and-now intervention that aligns well with the goals of supportive psychotherapy.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Psychosocial interventions for manic behavior to guide bedside assessment, documentation, and the next nursing action.
- A primary nursing role for a client in mania is to provide a safe, structured, and low-stimulus environment. This aligns with the principles of supportive therapy, not psychoanalysis.
- Nurses reinforce the strategies from supportive therapies by helping patients maintain routines, manage medications, and use simple problem-solving skills for daily challenges.
- Recognizing inappropriate vs. appropriate therapies is crucial for patient advocacy and interdisciplinary communication.
How to Approach the Question
- First, identify the core concepts in the question: 'manic behaviour' and 'supportive therapy'.
- Recognize the negative keyword 'except'. This means you are looking for the one option that does NOT fit.
- Recall the key features of a manic state: high energy, distractibility, impulsivity, grandiosity, and poor insight.
- Consider what kind of therapy would be most helpful for someone in this state. They need structure, focus on safety, and help with immediate problems.
- Evaluate each option: Cognitive, Interpersonal, and Problem-solving therapies are all structured and focus on current issues. Psychoanalysis is unstructured and focuses on deep-seated past conflicts.
- Conclude that the therapy requiring deep introspection into the past (Psychoanalysis) is the least appropriate and therefore the correct answer to the 'except' question.
Concept Tested & Keywords
- Concept Tested: Psychosocial interventions for manic behavior
- Stem keywords: manic behaviour, supportive therapy
- Lead-in keywords: except
- Negative lead-in flag: The question asks for the therapy that is NOT appropriate for a client with manic behavior.
Question ID
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Reference Book
E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 148-150
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 5624-5626
Practise the full DHS Staff Nurse - 2018 (Shift-2nd)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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