A client recently diagnosed with depression tells a nurse that she is 2 months pregnant and is reluctant to take an antidepressant medication. The client asks what other treatment options are available. Which type of therapy should a nurse recommend as an alternate treatment for depression?

Hallucinations are false sensory perceptions, often auditory, that are not based in reality. They commonly occur in psychotic disorders and may escalate under anxiety or stress. Managing hallucinations involves early recognition, reality testing, and strategies like therapeutic engagement. Anxiety can intensify perceptual disturbances, so interventions must address both symptoms. Clients should be taught to seek help, avoid isolation, and maintain stability through structured routines and medication adherence.

Rationale for correct answers

B. Seeking support and early intervention are key in managing hallucinations. Contacting a therapist when symptoms occur promotes safety and prevents progression into dangerous behavior.

Rationale for incorrect answers

A. Anxiety is a common side effect of psychotropic drugs and may also be a trigger for hallucinations, so this statement is inaccurate.

C. Support groups are useful for ongoing insight and coping, but they are not immediate interventions for acute hallucinations.

D. While sleep and nutrition are important, they are preventive—not active management strategies during hallucinations.

Take Home Points

• Hallucinations are often triggered or worsened by anxiety and stress.
• Early contact with mental health providers helps prevent escalation.
• Education should focus on active and practical responses to symptoms.
• Support groups are supplementary, not acute interventions.

Cognitive behavioral therapy (CBT) is a goal-oriented, structured form of psychotherapy that helps individuals identify and change negative thought patterns and behaviors. It is considered first-line for depression, especially when medication is contraindicated, such as during pregnancy. CBT addresses automatic thoughts, behavioral avoidance, and cognitive distortions. It is safe, non-invasive, and effective across all severity levels of depression, including for perinatal clients.

Rationale for correct answers

D. Thought restructuring and behavioral correction are central to CBT, which is evidence-based and recommended for depression during pregnancy when medication use is limited due to fetal risk.

Rationale for incorrect answers

A. Client-centered therapy focuses on empathy and unconditional positive regard but lacks structured methods for altering depressive thought patterns.

B. Gestalt therapy emphasizes present awareness and unresolved issues but is not first-line or evidence-based for treating depression in pregnancy.

C. Therapeutic touch therapy lacks scientific support for effectiveness in treating clinical depression and is not recommended as an evidence-based intervention.

Take Home Points

• CBT is a highly effective, non-pharmacologic therapy for depression, including during pregnancy.
• It works by modifying negative thoughts and behaviors.
• It is preferred when antidepressant use is avoided.
• Unlike talk therapies, CBT is structured and evidence-based.