Which motive is associated with fire-setting in individuals with pyromania?

The emergency room nurse is caring for a patient who ambulated into the triage room wearing sunglasses and a scarf. Upon request, the patient removed her sunglasses and scarf, revealing bruising around her neck and eyes in various stages of healing. The patient became hysterical and stated her husband tried to kill her. Which response by the nurse is the most appropriate?

The 22-year-old patient presented 6 weeks ago to the clinic to request a consultation for rhinoplasty. He reports his unsightly nose ruined his most recent relationship because his girlfriend would not stop staring at it; he has missed work due to embarrassment and has started to use makeup to make it look smaller. Upon assessment, the nose appears normal and proportional to his face. Psychoeducation was started and the patient has been compliant. However, he reports minimal improvement in his perception. The nurse advocates for which treatment next?