A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic to include in the client's plan of care?

Choice A reason: Playing a game of chess with the client may provide distraction, but it is not the most therapeutic approach for someone with severe depression. Clients in this state often struggle with concentration, motivation, and decision-making, making complex activities like chess overwhelming. While recreational activities can be supportive later in recovery, they are not the priority therapeutic intervention in the acute phase. Choice B reason: Spending time sitting with the client is the most therapeutic approach. Presence and nonverbal support are critical in severe depression, where clients may feel isolated, hopeless, or withdrawn. Simply being present conveys acceptance, safety, and support without placing demands on the client. This therapeutic communication technique helps build trust and reduces feelings of loneliness. This is the correct answer. Choice C reason: Giving the client choices of activities may seem supportive, but clients with severe depression often experience impaired decision-making and may feel overwhelmed by choices. This can increase anxiety or frustration rather than provide comfort. Structured, simple, and supportive interventions are more appropriate at this stage. Choice D reason: Encouraging decision-making is not therapeutic in the acute phase of severe depression. Clients may lack the energy, motivation, or cognitive clarity to make decisions, and pushing them to do so can increase feelings of inadequacy or guilt. Decision-making support can be introduced gradually as the client improves, but it is not the immediate therapeutic priority.