A patient tearfully says to a nurse,"I don't want to go on living now that my spouse has left me for someone else after 20 years.Our children are grown and don't need me.I just want to die." Which response is the most therapeutic?
A) "You're young, and you will manage well. I know several people your age who've actually done better after divorcing their spouses."
B) "It always seems bleak when we lose someone we've loved. Don't worry, it will work out-we just need to think this through."
C) "So your spouse is off having a midlife crisis and you are here thinking of killing yourself. Let's focus on how to make you feel better."
D) "I am very concerned about you wanting to die because your spouse left. Rather than trying to solve all the problems immediately let's focus on your feelings of hopelessness right now."

Question

Quizplus · Accepted Answer

The patient is demonstrating the cognitive distortions of dichotomous thinking (thinking in extremes) and overgeneralization.The patient is clearly in crisis and may be experiencing suicidal ideation.By identifying the most important problem and giving the patient permission to view one problem at a time with the therapist,the nurse is supporting effective problem solving by the patient.Using a cognitive behavioral approach,the nurse is able to perform a lethality assessment and then help the patient to expand alternatives and become a more flexible thinker.

A Patient Tearfully Says to a Nurse,"I Don't Want to Go