Fourfold dilemma- Primigravida, domestic violence, substance abuse and refusing assistance

pro-student · Nov 16, 2018

Spend a little time figuring out what she wants and working from there. She is likely to be resistant to any plan you (or anyone else) tries to impose on here. Investing in building some rapport and guiding her to make a plan. For instance, if she wants to continue the pregnancy and hopes to raise a healthy child, gentle ask questions to get her to consider what changes she needs to make to give her the best chance of success.

I'm a big fan of motivational interviewing because we can't change people but, if we can tap into what motivates them, we can help them make changes themselves. Remember the RULE of motivation:

Resist the "righting" reflex or the instinct to fix her.

Understand what motivates her because this is the only way you're going to have any chance of reaching her.

Listen with empathy using all those therapeutic communication skills we (should have) learned.

Empower her to make the changes she can and support her every step (even if that means a few steps backward).

Subby317 · Nov 16, 2018

Pro-student

Thanks for your suggestion. Loving the "Motivational interviewing" tactic. Thanks much!!!

FolksBtrippin, BSN, RN · Nov 21, 2018

What are you referring to when you say she is broken?

And what kind of assistance is she refusing?

Jules A, MSN · Nov 21, 2018

In psych we say you can't want it more than the patient. Continue to provide support and offer options, especially a therapist, but ultimately it is on them.

offlabel · Nov 21, 2018

Only one dilemma there...she's refusing help. Be available to her with your resources and guidance and go about your business.

Subby317 · Nov 21, 2018

What are you referring to when you say she is broken?

And what kind of assistance is she refusing?

Thanks for your response. By "broken" I mean " despondent" She is refusing prenatal although she voiced she wants the pregnancy, refusing housing assistance, although the child's father is "beating" her and she is refusing help for her substance use. Supportive care - when she wants - is being provided.

Subby317 · Nov 21, 2018

In psych we say you can't want it more than the patient. Continue to provide support and offer options, especially a therapist, but ultimately it is on them.

Thanks for your response. Supportive care is being provided as well as other available options. You are on point - we can not want it more than the patient. We just need to wait until she is ready.