A woman became severely depressed when the last of her six children moved out of the home 4 months ago. Since then she has neglected to care for herself, sleeps poorly, lost weight, and repeatedly states, "No one cares about me anymore

Question

I'm worthless.". After hospitalization, the nursing diagnosis of situational low self-esteem related to feelings of abandonment was identified. The nurse wishes to reinforce the patient's self-esteem by acknowledging the improvement in her personal appearance. She's wearing a new dress and has combed her hair. The most appropriate remark would be: a. "You look very nice this morning, Mrs. J.".
b. "I like the dress you're wearing, it's very pretty.".
c. "What brought about this glamorous transformation?"
d. "You've combed your hair and are wearing a new dress.".

Answer 1

D
Depressed patients usually see the negative side of things, even in positive comments. The meaning of compliments may be altered to "I didn't look nice yesterday" or "They didn't like my other dress.". People who do not feel they are attractive may have difficulty trusting others who compliment them, thinking that they are insincere; this can reduce trust in the therapeutic relationship. Neutral comments such as acknowledging the positive changes reinforce the desired behaviors while avoiding negative interpretations. Depressed persons usually have an impaired ability to appreciate humor, so attempts to use humor would not be therapeutic during the initial phase of treatment.