A 31-year-old female client who has been treated by the PMHNP for 10 years tells her she has been abusing her prescription for clonazepam (Klonopin). Using the principles of motivational interviewing, which of the following would be an affirming statement?

Choice A reason: Affirmation is a core principle of motivational interviewing. This statement validates the client’s courage and honesty, reinforcing her autonomy and self-awareness. It builds rapport and encourages continued openness, which is essential for collaborative treatment planning. Choice B reason: This statement is judgmental and undermines the therapeutic alliance. It reflects blame and hindsight bias, which can increase shame and resistance in the client. Choice C reason: While medical detox may be clinically appropriate, this directive lacks empathy and does not align with motivational interviewing principles. It bypasses the client’s readiness for change and may provoke defensiveness. Choice D reason: Taking partial blame may seem empathetic, but it shifts focus away from the client’s agency and responsibility. It also risks undermining the PMHNP’s professional boundaries and therapeutic neutrality.