Malou is diagnosed with major depression and spends majority of day lying in bed with sheet pulled over his head. Which of following approaches by nurse would be most rapeutic?

Correct Answer: B. Initiate contact with the client frequently

The nurse should initiate brief, frequent contacts throughout the day to let the client know that he is important to the nurse. This will positively affect the client’s self-esteem. Initially, provide activities that require minimal concentration (e.g., drawing, playing simple board games). Depressed people lack concentration and memory. Activities that have no “right or wrong” or “winner or loser” minimizes opportunities for the client to put himself/herself down.

• Option A: Eventually involve the client in group activities (e.g., group discussions, art therapy, dance therapy). Socialization minimizes feelings of isolation. Genuine regard for others can increase feelings of self-worth. Eventually maximize the client’s contacts with others (first one other, then two others, etc.). Contact with others distracts the client from self-preoccupation.
• Option C: When the client is in the most depressed state, Involve the client in a one-to-one activity. Maximizes the potential for interactions while minimizing anxiety levels. Involve the client in gross motor activities that call for very little concentration (e.g., walking). Such activities will aid in relieving tensions and might help in elevating the mood.
• Option D: Evaluate the client’s need for assertiveness training tools to pursue things he or she wants or needs in life. Arrange for training through community-based programs, personal counseling, literature, etc. Low self-esteem individuals often have feelings of unworthiness and have difficulty determining their needs and wants. Encourage the client to participate in a group therapy where the members share the same situations/feelings that they have. To minimize the feelings of isolation and provide an atmosphere where positive feedback and a more realistic appraisal of self are available.