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Difficulty: MediumTherapeutic Communication

A young adult client admitted to the behavioral health unit for severe depression stays in their room and states to the practical nurse, "I just do not see the point of trying anymore. Nobody would even notice if I were gone." Which of the following responses by the practical nurse demonstrate effective therapeutic communication? (Select all that apply.)

  1. "It sounds like you are feeling incredibly overwhelmed and alone right now."Answer
  2. B
    "Why do you believe that your friends and family would not miss you?"
  3. "I have some time, and I would like to just sit here with you for a while."Answer
  4. D
    "You have a long life ahead of you; try to focus on the positive things instead."
  5. "You are saying that you feel invisible to the people around you."Answer
  6. F
    "Do not worry, these dark thoughts will fade once your treatment plan takes effect."

Answer

The effective therapeutic responses are reflecting the client's feelings of being overwhelmed, offering to sit with the client in silence, and restating their feeling of being invisible.
The correct options utilize validated therapeutic techniques: reflection of feelings, offering self, and restating. Acknowledging that the client feels overwhelmed validates their experience. Offering to sit with the client provides non-judgmental presence and support, demonstrating that someone does care and notice them without forcing them to speak. Restating their sense of invisibility encourages them to explore and articulate their feelings further. All of these methods build trust without dismissing the client's distress.

Step-by-Step Solution

1
Analyze the client's statement and emotional state.
The client is expressing profound hopelessness, isolation, and potential suicidal ideation.
Understanding the core emotional message is necessary to select interventions that provide emotional validation and promote safety.
2
Evaluate the response options for therapeutic communication techniques.
Responses that reflect feelings, restate the client's words, and offer the nurse's presence are identified as therapeutic.
These techniques demonstrate empathy, build trust, and keep the channels of communication open without placing demands on the client.
3
Identify and eliminate non-therapeutic communication blocks.
Responses that ask 'why', give advice, or offer false reassurance are eliminated.
These communication blocks invalidate the client's feelings, induce defensiveness, and quickly shut down further sharing.

Key Concept

Therapeutic Communication
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Topics

Therapeutic Communication

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