A nurse is caring for a client who has narcissistic personality disorder. Which of the following treatments should the nurse recommend?

Choice A reason: Schema-focused therapy targets deep beliefs, often for borderline personality, not narcissistic traits like grandiosity. It’s less tailored to NPD’s need for self-esteem regulation and empathy building. Evidence for NPD is limited, making it less suitable than CBT for this client. Choice B reason: Cognitive behavioral therapy (CBT) addresses distorted thinking and behaviors in NPD, like entitlement, fostering realistic self-view and empathy. It’s evidence-based for personality disorders, adaptable to grandiosity and interpersonal issues. This aligns with NPD treatment goals, making it the recommended choice. Choice C reason: Assertiveness training enhances communication but doesn’t tackle NPD’s core—lack of empathy or inflated self-image. It may reinforce dominance, not humility, unhelpful for this disorder. This superficial approach lacks depth for personality change, so it’s not ideal. Choice D reason: Response prevention therapy suits OCD, preventing compulsions, not NPD’s interpersonal or ego issues. It’s irrelevant to narcissistic traits like arrogance or validation-seeking. This mismatch with the disorder’s needs makes it an incorrect treatment option here.