Chronic low self-esteem r/t impaired cognitive self-appraisal AEB negative feedback
about self through client’s statement of, “I don’t have any good qualities” and
client seeking validation.
Client will verbally give
an accurate and nonjudgmental account of three positive qualities as well as identify
two areas that he wishes to improve by [Month] 8, [Year] at 1400.
Client will identify one
or two strengths by [Month] 14, [Year] at 1400.
1: Work with client on areas
that he or she would like to improve using problem-solving skills. Evaluate need
for more teaching in this area.
Rationale: Feelings of low
self-esteem can interfere with usual problem-solving abilities (Varcarolis, pg 171).
2: Work with client to identify
cognitive distortions that encourage negative self-appraisal.
distortions reinforce negative,
inaccurate perception of the world (Varcarolis, pg. 170).
Developing both self-acceptance
and self-esteem have been identified as ways to enhance cognitive interventions
(Macinnes, pg 483).
1: Assess existing strengths
and coping abilities, and provide opportunities for their expression and recognition.
Rationale: Supporting a client’s
beliefs and self-rejection and helping them cope can affect self-esteem (Ackley
& Ladwig, pg. 716).
2: Reinforce the personal
strengths and positive perceptions that the client identifies.
Rationale: Clients with low
self-esteem need to have their existence and value confirmed (Ackley & Ladwig,
Evaluation set for [Month]
8, [Year] at 1400. Client has made some progress toward goal; on [Month] 14, [Year]
he was able to identify 2 strengths and did not reject positive self feedback.
Goal met. As of [Month] 14,
[Year] at 1400 client was able to identify two strengths: being a good listener
and having good communication skills.
Client states that he doesn’t
know of areas that he could improve on. He thinks that he has reached his maximum
potential. Nursing student worked with client to identify that he focuses on negative
qualities while discounting his positive attributes. Client states that he would
like to work on being able to accept positive feedback.
Assessment of client’s
strengths shows that he is
very intelligent and can hold a good conversation. The nursing student worked with
the client to identify his strength in communication.