A 17-year-old female with a self-admitted opioid addiction is seen by the nurse in a mental health clinic. Which intervention would the nurse not consider in establishing a therapeutic relationship?

  1. discuss the impact of substance use
  2. require the client to attend all therapy sessions
  3. explore alternative approaches to managing stress
  4. assess the presence of other psychiatric disorders
Number 2 is correct.
Rationale: Attendance at all therapy sessions should be an expectation established within the confines of the therapeutic relationship. Requirement of attendance places the client in a position where failure to attend all sessions, rather than being a point for learning, becomes a mechanism for punishment. Using this approach will not assist the client in achieving the desired outcome of abstinence from drugs. Establishing a therapeutic relationship with a client who is addicted to drugs requires open, supportive communication consistent with options 1 and 3. Determining the presence of a concurrent psychiatric disorder is necessary to provide a comprehensive therapeutic approach.