Mental Health Nursing
A nurse was assigned to facilitate a group therapy for a group of patients with cluster a personality…
A nurse was assigned to facilitate a group therapy for a group of patients with cluster a personality disorders ( odd eccentric group) which of the following should the first nursing intervention ?
Explanation
Core Concept: Cluster A personality disorders include paranoid, schizoid, and schizotypal personality disorders, characterized by odd or eccentric behavior, social withdrawal, suspiciousness, and discomfort in relationships. The FIRST nursing intervention is to build a therapeutic relationship because trust is essential before education, group participation, or behavior change can occur.
Clinical Presentation: • Mistrust, emotional detachment, limited eye contact, suspiciousness, magical thinking, unusual perceptions, and poor group engagement. • Complications include isolation, treatment dropout, anxiety, depression, and impaired social functioning.
Diagnosis: 1) First-line: psychiatric assessment, mental status examination, and DSM-based evaluation of personality patterns. 2) Gold standard: comprehensive psychiatric/psychological assessment over time; no laboratory test diagnoses personality disorder.
Management: Acute - establish rapport using a calm, respectful, non-threatening approach, maintain consistent boundaries, and reduce stimulation. Definitive/long-term - ongoing individual and group therapy, social skills training, supportive counseling, and medication only for comorbid symptoms such as anxiety, depression, or psychosis.