A patient with borderline personality disorder has been hospitalized several times after self-injurious behavior and suicide attempts.The patient has entered dialectical behavior therapy on an outpatient basis.During therapy,the advanced practice nurse has been counseling her regarding self-harm behavior management.Today the patient called the nurse and reported "feeling empty and anxious" and wants to cut herself.Which response would best help in this situation?

Question

Quizplus · Accepted Answer

The patient has responded appropriately to the urge to harm herself by calling a helping individual.The nurse can assist the patient to choose an alternative to self-injury.Except when the patient is judged to be at risk of suicide as well,hospital or crisis center admissions are generally discouraged in favor of guiding the patient to use internal controls to manage urges to self-injure.This is designed to minimize dependence on hospitalization for safety and promote independence and adaptive coping.Taking a sedative and going to sleep should not be the first-line intervention,because sedation may reduce the patient's ability to weigh alternatives to mutilating behavior,and using medications to deal with stress (especially in the absence of other adaptive coping alternatives such as relaxation exercises)could increase the risk of drug abuse or dependence.

A Patient with Borderline Personality Disorder Has Been Hospitalized Several