This is the discussion of student where

This is the discussion of student where they answer these regarding someone with borderline personality. How would you use therapeutic communication and principles of cognitive behavioral therapy with the client? Describe your assessment process. What are some likely co-morbid conditions? List one nursing diagnosis and an appropriate nursing intervention. What interdisciplinary referrals might be appropriate? This is the discussion that students answer.Please reply on each students answer. Share your opinion ,comment or maybe experience. Student 1.The above story of Ms. S reflects the difficulties of communicating with someone who suffers from borderline personality disorder. Ms. S shows mood swings, sometimes suspicion, and inconsistent ways of expressing her needs, which make it difficult to communicate with such a person. Ms. S is characterized by high emotional reactivity. In other words, she reacts to everything much more intensely. .Ms. S is looking for a novelty, is impulsive, and has a tendency to risky behavior. On the other hand, she is very sensitive to criticism and any form of real or imaginary rejection, in fact, such a person is very much about recognition and acceptance from the environment. An inevitable conflict arises here because often, due to the impulsive reactions of Mrs. S with borderline disorder, she does not receive the expected approval and acceptance from the environment or the closest people. Ms. S craves both stimulation and novelty and, on the other hand, constancy, predictability, and unconditional acceptance, which can be difficult to satisfy at the same time. However, there is often great helplessness behind it, not bad intentions. Ms S is particularly prone to severe depression and substance abuse. In the case of Ms. S, I would use SET, S-support, E-empathy, and T-truth. It is a communication system that is supposed to make communication efficient, especially when it is needed in crisis situations. The best treatment for Ms. S would be a referral to a psychiatrist and psychotherapy. Still, the best effective treatment would be dialectical behavioral therapy which will help Ms. S replace maladaptive behaviors with healthier coping skills. Student 2.There are multiple ways to speak with patients with borderline personality disorder. It is very challenging to speak with them so using therapeutic communication is essential. First I would listen to their concerns. Active listening is important. A nurse should not try to argue or try to interrupt patients while they are voicing their concerns and making statements. You can build a trust relationship by doing this. Moreover, a nurse should never judge a patient. You should never make your patient feel guilty. My assessment would include asking Ms. S regarding her moods and condition. When did this start or what aggravates her that lead to this behavior. A complete mental status examination or MSE is what I would do as assessment process. Possible co-morbid conditions with these are major depressive disorder and substance use disorder. Ms. S is often feel rejected by someone she loves. Although, substance use was not mentioned. Substance use disorder is often co-morbid with mental illness such as bipolar disorder, anxiety, depression etc. I would refer her to psychiatrist, psychiatrist, and social worker. Ms. S could definitely benefit from therapy. A psychiatrist might be needed for medications if needed. Student 3.A priority action with this client would be to establish trust and the right rapport, promoting a psychological climate that would facilitate positive change and growth. Establishing trust with this client would help set clear boundaries and focus the emerging therapeutic relationship on the client’s needs. With this client, it would be beneficial to apply professional interpersonal skills in communicating with her to gain insight into how she perceives herself; while introducing cognitive behavioral therapy, helping the client recognize how her thinking might influence her emotion and behavior. Implementing this can help her detect and modify automatic thoughts and schemas, especially those associated with emotional symptoms such as anxiety and anger. Using cognitive behavioral therapy can assist the client in thinking about what she is thinking to bring autonomous cognitions into conscious awareness and control. While there is no test to assess BPD, mental health professionals use psychological tests and assessments to learn about the patient; they gather information about the client’s symptoms, life experiences, and family history. Borderline personality Disorder usually coexists with other symptoms like depression, anxiety, bipolar disorder, eating disorder, and substance abuse . Impaired social interaction, evidenced by dysfunctional interaction with peers, family, and coworkers. I would limit manipulative behavior, assess needs and encourage skills training, monitor my thoughts and feelings constantly regarding my response to the patient, and establish a reward system. I would make referrals to a psychiatrist, psychologist, and social worker. Student 4.Cognitive behavioral therapy (CBT) is a treatment approach that helps you recognize negative or unhelpful thought and behavior patterns. The aim is to help the patient change how they think about, feel, emotion, or interpret situations, as well as the actions they take in their daily life. This technique is best used for clients dealing with depression. First, I will have good therapeutic communication with the client, which includes being patient, realistic, listening actively, empathy I will be, honest, and keeping my word. I will let her share her feelings and thought. Addressing this situation can help you deal with the problems as they arise, which can help you deal with negativity. First, I will assess my client`s mental status, when their situation started, the cause of it, and how long she has been dealing with it. My priority will be safety and ensuring they will not harm themselves or others. BPD is a personality disorder whose primary symptoms include significant emotional distress and impairment of interpersonal or occupational functioning. A client has shown enough evidence of emotional distress and occupational functioning. Tools available to screen BPD, such as MSI-BPD, developed by Dr. Mary Zanarini, and other structured interview processes recommended by APA. A patient with BPD has difficulty being alone, and relationship breakups worsen anxiety and distress. I’d use both dialectical behavior therapy (DBT) and schema-focused therapy, which are proven to be effective in reducing BPD symptoms. Nursing intervention includes maintaining a neutral, calm, & respectful manner and discouraging a client from making repetitive self-blaming and negative remarks. Making her go see psychotherapy, a psychiatrist. I would also recommend continuing her appointments and medication for an anti-depressant. Student 5.In order to keep this patient on their prescribed medicine for an extended period of time, the nurse will need to engage in years of psychotherapy and pharmacologic intervention. The antidepressant prescription and follow-up visits with her doctor are other suggestions I’d make. It’s not only that I think she’d benefit from mentalization-based treatment that I’d promote to others (MBT). Mentalization-based therapy (MBT) is a kind of talk therapy that emphasizes the importance of being in the present moment and actively recognizing and labeling one’s own thoughts, emotions, and reactions. Using MBT, you are encouraged to consider your options before acting Indicators of borderline personality disorder (BPD) include extreme emotional discomfort and a decline in social or occupational performance. There is sufficient proof in Ms. S’s case that she is experiencing emotional distress and is unable to perform her job duties. The MSI-BPD, created by Dr. Mary Zanarini, and other structured interview processes approved by the APA are only two examples of the various techniques available for screening for BPD. Ms. S has shown a diagnostic crisis that is consistent with a meaningful relationship ending. Patients with borderline personality disorder (BPD) have a hard time being alone, and relationship breakdowns only make their anxiety and discomfort worse. Dialectical behavior therapy (DBT) and schema-focused therapy are two approaches that I would utilize to treat BPD. It is important for nurses to intervene when patients blame themselves or make derogatory comments about themselves by striking an attitude of neutrality, calmness, and respect. Helping her manage and gain emotional control would be the primary goal of my intervention. She needs my assistance as a nurse to recognize her emotions and learn to live with them without resorting to destructive behaviors like cutting or other self-harm. In order to keep this patient on their prescribed medicine for an extended period of time, the nurse will need to engage in years of psychotherapy and pharmacologic intervention. The antidepressant prescription and follow-up visits with her doctor are other suggestions I’d make. It’s not only that I think she’d benefit from mentalization-based treatment that I’d promote to others (MBT). Mentalization-based therapy (MBT) is a kind of talk therapy that emphasizes the importance of being in the present moment and actively recognizing and labeling one’s own thoughts, emotions, and reactions. Using MBT, you are encouraged to consider your options before acting. SCIENCE HEALTH SCIENCE NURSING NUR 2488

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