A nurse is caring for a patient with a mental health disorder. Which approach best supports therapeutic care?

Choice A reason: Including the child in group activities promotes socialization but is not operant conditioning, which uses rewards to reinforce specific behaviors like speech. This approach lacks direct reinforcement, making it ineffective for the targeted behavior, thus incorrect.

Choice B reason: Observing others talking may model behavior but is not operant conditioning, which requires direct reinforcement of the desired action (speech). Passive observation does not provide the reward structure needed to encourage speech, making this choice incorrect.

Choice C reason: Operant conditioning uses positive reinforcement, like giving a treat for speaking, to increase the desired behavior. This directly rewards the child’s speech, aligning with behavioral psychology principles to encourage verbalization, making this the correct choice.

Choice D reason: Relaxation techniques address anxiety but are not operant conditioning, which focuses on reinforcing specific behaviors with rewards. They do not directly encourage speech, making this choice incorrect for the behavioral approach specified in the treatment plan.

Choice A reason: Asking if the client felt this way before hospitalization focuses on past feelings, which may not address the current emotional state or therapeutic needs. While it gathers history, it lacks empathy and does not encourage the client to elaborate on their current concerns, making it less therapeutic.

Choice B reason: Reflecting the client’s statement by asking if they feel the setting is wrong demonstrates active listening and empathy, key components of therapeutic communication. It encourages the client to express feelings, fostering trust and exploration of their concerns, aligning with psychiatric nursing principles, making this the correct choice.

Choice C reason: Suggesting the client discuss concerns later with a doctor dismisses their current emotional state, potentially undermining trust in the nurse-client relationship. It avoids immediate engagement and fails to address the client’s feelings, which is critical in psychiatric care, making this response non-therapeutic and incorrect.

Choice D reason: Labeling the client’s statement as inappropriate is judgmental and dismissive, hindering therapeutic communication. It may increase the client’s sense of alienation or shame, contrary to psychiatric nursing goals of building trust and validating feelings. This response is non-therapeutic and does not support the client’s emotional needs.