A chief task during the termination phase of a group is to take what has been learned in group and transition to life without the group. The end of a group can be a significant loss for members, who may experience loss and grief and respond with sadness or anger. It is unlikely he would have nothing to say; at the very least, he could be responding to the comments of others even if not focusing on his own issues. He may wish to give quieter members a chance to talk, but again, this would not require or explain his complete silence. Some members, faced with only two remaining sessions, may be becoming more dominant under this pressure of time, but here too this is unlikely to lead a previously active participant to fall completely silent. The member is not attention-seeking.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 34-6, 7 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
20. A patient in a support group says, “I’m tired of being sick. Everyone always helps me, but I
nd
_x
will be glad when I can help someone else.” This statement reflects a. altruism. b. universality. c. cohesiveness. d. corrective recapitulation. ANS: A
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_a
Altruism refers to the experience of being helpful or useful to others, a condition that the patient anticipates will happen. The other options are also therapeutic factors identified by Yalom.
an
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 34-18 (Table 34-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 21. During a support group, a patient diagnosed with schizophrenia says, “Sometimes I feel sad
:t
es
tb
that I will never have a good job like my brother. Then I dwell on it and maybe I should not.” Select the nurse leader’s best comment to facilitate discussion of this issue. a. “It is often better to focus on our successes rather than our failures.” b. “How have others in the group handled painful feelings like these?” c. “Grieving for what is lost is a normal part of having a mental disorder.” d. “I wonder if you might also experience feelings of anger and helplessness.”
ay
ANS: B
eB
Asking others to share their experiences will facilitate discussion of an issue. Giving information may serve to close discussion of the issue because it sounds final. Suggesting a focus on the positives implies a discussion of the issue is not appropriate. Suggesting other possible feelings is inappropriate at this point, considering the patient has identified feelings of sadness and seems to have a desire to explore this feeling. Focusing on other feelings will derail discussion of the patient’s grief for his perceived lost potential.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 34-8, 9, 18 (Table 34-1), 26 (Table 34-6) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
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