A 52-year-old client is admitted for surgery to treat lung cancer and says, I was an alcoholic for 15 years, and now that I’m 25 years sober, I’m being punished. Which statement would be therapeutic?

A 52-year-old client is admitted for surgery to treat lung cancer and says, I was an alcoholic for 15 years, and now that I’m 25 years sober, I’m being punished. Which statement would be therapeutic?

• A. You're overreacting
• B. It could be worse
• C. You're not responsible
• D. Because you seem to be blaming yourself unnecessarily, perhaps we can talk about your illness and what you can expect after surgery

Answer: (D)

The main idea is therapeutic communication that validates a patient’s feelings and guides the conversation toward coping and practical planning. When the patient expresses that they feel punished for past alcohol use, the best response acknowledges that self-blame is present but unnecessary, and then gently shifts to discussing the illness and what to expect after surgery. Saying, “Because you seem to be blaming yourself unnecessarily, perhaps we can talk about your illness and what you can expect after surgery,” does this by: - recognizing the emotion without judgment, which helps the patient feel heard and safe - normalizing the guilt as a common reaction rather than a fixed truth - inviting discussion about the medical condition and the upcoming procedure, which provides information and reduces anxiety - creating an opportunity to address postoperative expectations, recovery plans, and support needs This approach strengthens rapport, supports emotional coping, and lays the groundwork for informed decision-making and a smoother recovery.

The main idea is therapeutic communication that validates a patient’s feelings and guides the conversation toward coping and practical planning. When the patient expresses that they feel punished for past alcohol use, the best response acknowledges that self-blame is present but unnecessary, and then gently shifts to discussing the illness and what to expect after surgery. Saying, “Because you seem to be blaming yourself unnecessarily, perhaps we can talk about your illness and what you can expect after surgery,” does this by:

• recognizing the emotion without judgment, which helps the patient feel heard and safe

• normalizing the guilt as a common reaction rather than a fixed truth

• inviting discussion about the medical condition and the upcoming procedure, which provides information and reduces anxiety

• creating an opportunity to address postoperative expectations, recovery plans, and support needs

This approach strengthens rapport, supports emotional coping, and lays the groundwork for informed decision-making and a smoother recovery.