A client with depression says: 'I've been feeling a little better this week. I actually cleaned my apartment for the first time in months.' The nurse's MOST therapeutic response is:

THERAPEUTIC RESPONSE TO PROGRESS IN DEPRESSION: The best response: (1) VALIDATES the significance without overpromising ('meaningful step' acknowledges it without guaranteeing recovery); (2) EXPLORES the client's experience ('How did it feel?') — opens conversation about whether the client noticed a change in their mood, what the accomplishment meant to them, and helps them identify their own recovery resources; WHAT'S WRONG WITH THE OTHERS: 'You'll be back to normal in no time' — false reassurance; recovery from depression is not linear; sets the client up for disappointment and guilt if they have a setback; 'Keep it up or you'll feel bad again' — threatening and adds pressure; depression already involves guilt; this comment instrumentalizes the achievement and threatens; 'You should have cleaned sooner' — blaming, shaming; depression causes avolition (inability to initiate activities), not laziness — this comment lacks understanding of the illness.

Strengths-based approach: Exploring what the accomplishment felt like helps the client build their own narrative of recovery.