A nurse is working with a client who has been diagnosed with major depressive disorder and is participating in cognitive behavioral therapy (CBT). Which nursing intervention best supports the client's CBT treatment goals?
1Encouraging the client to focus on past traumatic experiences and their emotional impact
2Providing reassurance that negative thoughts are normal and will pass with time
3Suggesting the client avoid situations that trigger negative thinking patterns
4Helping the client identify and challenge negative thought patterns and develop coping strategies✓ 정답
해설
CBT focuses on identifying and modifying negative thought patterns. The best nursing intervention is helping the client identify and challenge these patterns while developing coping strategies, which aligns with CBT's active, present-focused approach.
심화 해설
Clinical Judgment
This question assesses your ability to understand the core principles of Cognitive Behavioral Therapy (CBT) and determine how a nurse can support them. The treatment goal for a patient with Major Depressive Disorder is to modify negative and distorted thought patterns and develop new behaviors and coping skills. Therefore, the most effective nursing intervention is one that directly supports the fundamental goals of therapy: 'Cognitive Restructuring' and 'Developing Coping Strategies'.
임상 시나리오
Clinical Practice Guide
The role of a nurse supporting CBT differs from that of a therapist. The nurse acts as a 'coach' or 'supporter' who helps reinforce and practice the skills learned in therapy sessions in daily life.
Caution
* Caution! Options 1, 2, and 3 are approaches that go against CBT principles or are ineffective. Option 1 is closer to psychodynamic therapy, Option 2 leads to passive neglect of the problem, and Option 3 reinforces avoidance behavior. In SATA (Select All That Apply) questions, these 'attractive wrong answers' may appear together.
* Nursing interventions should always be oriented toward the Present and the Future. CBT focuses on changing current dysfunctional thoughts and behaviors rather than analyzing past causes.
핵심 개념
인지행동치료 (Cognitive Behavioral Therapy, CBT) — A structured, goal-oriented psychotherapy based on the model that thoughts (cognition), emotions, and behaviors are interconnected and influence each other. It aims to identify and challenge negative/irrational thought patterns, transforming them into more realistic and adaptive thoughts and behaviors.
주요우울장애 (Major Depressive Disorder, MDD) — A mood disorder characterized by persistent depressed mood or loss of interest/pleasure (anhedonia) lasting at least 2 weeks. It is accompanied by other symptoms such as changes in sleep, appetite, energy, concentration, self-esteem, or suicidal thoughts.
인지 왜곡 (Cognitive Distortion) — Unrealistic or irrational thought patterns. Examples: all-or-nothing thinking, overgeneralization, mind reading, minimization/magnification, etc. These are key targets in CBT.
인지 재구성 (Cognitive Restructuring) — One of the core techniques of CBT. The process of recognizing irrational or negative thoughts, examining the evidence for them, and replacing them with more balanced and accurate thinking.
대처 전략 (Coping Strategies) — Cognitive and behavioral efforts used to cope with stress or difficult situations. In CBT, it helps develop both problem-focused coping (problem-solving) and emotion-focused coping (emotion regulation) strategies.