The mental health clinic nurse is evaluating the treatment plan for a client with obsessive-compulsive disorder who counts backward from 5 to 1 many times a day. Which of the following client statements indicates progress toward effective coping? Select all that apply.

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Obsessive-compulsive disorder (OCD) is characterized by obsessions (ie, persistent thoughts, impulses, or images) and/or compulsions (ie, ritualistic, repetitive behaviors). Clients often use compulsions as a means of suppressing anxiety induced by obsessions. The rituals can be severe enough to alter daily activities and social relationships. Although the client can recognize that a compulsive behavior is irrational and excessive, the client continues to perform the rituals to reduce anxiety. Treatment options for OCD include anxiety management to reduce or eliminate compulsive behaviors. Progress in the treatment plan may include: Recognizing anxiety triggers (eg, heavier workload) and using relaxation or redirection techniques (eg, deep breathing, exercise) to avoid engaging in compulsive responses (Options B and E) Using behavioral techniques (eg, exposure and response prevention) to decrease or eliminate the time spent performing the ritualistic behavior (Option C) (Options A and D) Rationalizing ritualistic behavior and avoiding anxiety-producing situations do not indicate progress toward effective coping. Educational objective: Obsessive-compulsive disorder is characterized by obsessions and/or compulsions engaged in to relieve anxiety. Treatment effectiveness is demonstrated by the client's ability to identify situations that increase anxiety and develop healthy coping techniques to manage anxiety (eg, deep breathing, exercise) that replace the ritualistic behaviors.

The Mental Health Clinic Nurse Is Evaluating the Treatment Plan