During a therapy session, a patient with a new SCI becomes verbally aggressive. The most appropriate response by the therapist is to:

During a therapy session, a patient with a new SCI becomes verbally aggressive. The most appropriate response by the therapist is to:

• A. End the session immediately and refuse to treat the patient until they apologize
• B. Become defensive and explain that the patient's progress is their own responsibility
• C. Remain calm, allow the patient to express their frustration without reacting, and continue to provide supportive care
• D. Agree with the patient and apologize for the therapy program

Answer: (C)

The situation tests the ability to de-escalate verbal aggression and maintain a therapeutic alliance during SCI rehabilitation. The best response is to stay calm, not react emotionally, and let the patient express their frustration while continuing to provide supportive care. This approach lowers arousal, models constructive coping, and keeps the session focused on rehabilitation goals. It also helps uncover the underlying concerns—such as fear, pain, or loss of independence—so they can be addressed without abandoning the patient or creating a punitive atmosphere. Other approaches that end the session or blame the patient, or that placate them by agreeing with the program, fail to establish boundaries, can reinforce negative behavior, and disrupt safety and progress. The goal is to support the patient while maintaining appropriate professional boundaries and continuing the care plan.

The situation tests the ability to de-escalate verbal aggression and maintain a therapeutic alliance during SCI rehabilitation. The best response is to stay calm, not react emotionally, and let the patient express their frustration while continuing to provide supportive care. This approach lowers arousal, models constructive coping, and keeps the session focused on rehabilitation goals. It also helps uncover the underlying concerns—such as fear, pain, or loss of independence—so they can be addressed without abandoning the patient or creating a punitive atmosphere.

Other approaches that end the session or blame the patient, or that placate them by agreeing with the program, fail to establish boundaries, can reinforce negative behavior, and disrupt safety and progress. The goal is to support the patient while maintaining appropriate professional boundaries and continuing the care plan.