A nurse is caring for a client who was recently diagnosed with somatic symptom disorder. The client says to the nurse, "I don't understand, they can't find anything medically wrong with me. I guess I will never feel better." Which of the following responses is the most therapeutic?

A. This response is not fully therapeutic because it implies hopelessness by stating there is no cure and offers vague reassurance (“I am sure you will feel better someday”). False reassurance does not validate the client’s feelings or promote active coping strategies. B. Focusing solely on the physical symptoms reinforces the client’s preoccupation with somatic complaints. In somatic symptom disorder, the goal is not to validate the illness as medically unexplained in a way that increases symptom focus, but to help the client manage distress and improve functioning. C. This response is confrontational and may make the client feel defensive or judged. Asking whether the client lacks confidence in the medical team shifts the focus away from therapeutic support and may damage rapport. D. This is the most therapeutic response because it acknowledges the client’s distress while emphasizing collaborative management. It focuses on developing coping strategies and symptom management rather than debating whether symptoms are “real.” This approach promotes empowerment, supports adaptive coping, and aligns with treatment goals for somatic symptom disorder.