A nurse is caring for a client diagnosed with borderline personality disorder who becomes angry, raises their voice, and begins pacing during a group therapy session. What is the most appropriate initial action for the nurse to take?
Ask the client to remain in the session to observe group dynamics and manage their emotions more effectively.
Encourage the client to step outside the group with the nurse to discuss their feelings in a calm environment.
Warn the client that disruptive behavior will result in them being removed from the group.
Ignore the behavior to avoid reinforcing attention-seeking tendencies.
The correct answer supports the nurse's role in de-escalating the situation using behavioral management techniques. Encouraging the client to step outside the group removes them from the source of their heightened emotional state, allowing their emotions to de-escalate in a more controlled environment. Offering therapeutic support while respecting their autonomy is key. Other options are incorrect because they either jeopardize group safety by allowing escalation to continue, do not address the client's immediate emotional needs, or act in a punitive way, which would damage therapeutic rapport.
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Why is stepping outside with the client effective in managing borderline personality disorder (BPD) outbursts?
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NCLEX RN
Psychosocial Integrity
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