A female client who was the victim of acquaintance rape 2 months ago is receiving therapy for posttraumatic stress disorder (PTSD). She says to the nurse, "It's all my fault. I should have known not to accept a drink from someone I just met in a bar." What is the best response by the nurse?

Question

Quizplus · Accepted Answer

One of the common features of PTSD is a persistent distorted perception about the cause of the traumatic event that leads the affected individuals to blame themselves or others. Clients may be in a persistent, negative emotional state of guilt and/or shame and also believe that they are responsible for what happened. This is particularly true in cases of rape. A pervasive culture of "blaming the rape victim" also contributes to clients' perception that the rape was somehow their own fault. Providing a realistic perspective of the rape may help clients develop a more objective view of their perceived role in the traumatic event and may reduce feelings of self-blame and guilt. The nurse needs to reinforce repeatedly that rape is never the victim's fault (Option C). (Option A) This is a nontherapeutic response as it reinforces the client's feelings of self-blame and guilt. The best therapeutic response should reinforce that the client is not to blame for the rape. (Option B) This is a nontherapeutic response; it does not assist in changing the client's perception of the traumatic event and implies that the client should not cope with the experience at all. (Option D) This is a nontherapeutic response. Clients cannot simply make negative feelings disappear; these need to be resolved through therapy. Educational objective: Clients who suffer from PTSD often experience feelings of guilt and shame; they believe that they are responsible for what happened and that, somehow, they could have prevented the traumatic event. Using therapeutic communication, the nurse needs to convey that what happened was not their fault.

A Female Client Who Was the Victim of Acquaintance Rape