A client with generalized anxiety disorder (GAD) reports constant worry, muscle tension, difficulty sleeping, and difficulty concentrating for more than 6 months. Which non-pharmacological nursing intervention is MOST evidence-based?

NON-PHARMACOLOGICAL INTERVENTIONS for anxiety disorders include several evidence-based approaches. RELAXATION TECHNIQUES are particularly relevant to PN practice: DIAPHRAGMATIC (BELLY) BREATHING — slow, deep breaths (4-count inhale, hold, 4-count exhale) activates the parasympathetic system, counteracting the sympathetic 'fight or flight' response; PROGRESSIVE MUSCLE RELAXATION (PMR) — systematically tensing and releasing muscle groups to reduce muscle tension and overall arousal; MINDFULNESS MEDITATION — focused attention on the present moment, reducing rumination; GUIDED IMAGERY — visualizing calm, peaceful scenes; BIOFEEDBACK — using physiological monitoring to learn to control physiological responses. ADDITIONAL INTERVENTIONS: cognitive-behavioral therapy (CBT) is the GOLD STANDARD psychotherapy for GAD; exercise (regularly reduces anxiety); sleep hygiene; social support; limiting caffeine and alcohol (both worsen anxiety). PHARMACOLOGICAL OPTIONS for GAD: FIRST-LINE: SSRIs (sertraline, escitalopram, paroxetine) and SNRIs (venlafaxine, duloxetine) — daily medications, takes weeks to reach full effect; BUSPIRONE — non-addictive, takes 2-4 weeks for effect; SHORT-TERM: benzodiazepines (lorazepam, clonazepam) — effective quickly but risk of dependence, cognitive impairment especially in elderly. 'Just stop worrying' is dismissive and harmful — anxiety is not a choice. Avoiding triggers often INCREASES anxiety long-term by reinforcing avoidance behavior. PN ROLE: teach and reinforce relaxation techniques; coach breathing exercises; provide structured, calm environment; support engagement with therapy; monitor medications and side effects.