A patient says,"I've been sick a lot this last year but I'm still the biggest seller.I think my boss wants me to leave because a big change in our health insurance plan was implemented last week." The nurse responds:
A) "So you've been sick but you're the best seller. That makes you a valued employee."
B) "It's hard to get up one day and find that you're the oldest person in any group. It's only natural that you'd be sicker than everyone else."
C) "You're still the best seller. It's important not to be suspicious of what is probably only a necessary change in health insurance coverage."
D) "So you think that while you're still the best seller the fact you've been sick a lot this year is a problem? You feel that your employer's change in health insurance indicates they want you to leave?"

Question

Quizplus · Accepted Answer

The patient is demonstrating the cognitive distortion of personalization and arbitrary inference.The therapeutic communication that reflects a cognitive behavioral assessment is the one that first asks,"What is the problem?" Identifying the problem from the patient's perspective in a neutral,nonjudgmental style of communication helps the patient to take this first step.The antecedent and feared consequences also are identified.

A Patient Says,"I've Been Sick a Lot This Last Year