NCLEX · Therapeutic Communication

A client with depression has not spoken during the last 10 minutes of a scheduled therapeutic interaction. What is the MOST therapeutic nursing response?

Correct answer

Sit quietly with the client, maintaining an open, accepting posture, using therapeutic silence — silence communicates that you are present, attentive, and comfortable without demanding conversation

  1. A End the session — silence means the client wants to be alone
  2. B Ask a series of questions to fill the silence
  3. C Sit quietly with the client, maintaining an open, accepting posture, using therapeutic silence — silence communicates that you are present, attentive, and comfortable without demanding conversation
  4. D Leave and return when the client is ready to talk

Why this is the answer

THERAPEUTIC SILENCE is an active, deliberate communication technique — not passive waiting. WHAT THERAPEUTIC SILENCE COMMUNICATES: 'You don't have to perform or produce for me'; 'I am here and attentive without demanding you speak'; 'Whatever you are experiencing right now is okay'; 'You have space to process your thoughts'; VALUE IN DEPRESSION: Depressed clients often feel a social obligation to converse that they lack the energy to fulfill — releasing this pressure through silence can be deeply comforting; silence may precede important disclosures that emerge when the client feels no pressure to speak; DURATION: 30 seconds to 2-3 minutes of silence can feel like a very long time — allow it without breaking it anxiously; BODY LANGUAGE DURING SILENCE: Relaxed, open posture; gentle eye contact; forward lean (interested, not hovering); nodding if client makes eye contact; WHEN TO BREAK SILENCE: When the client appears distressed, panicked, or waiting for you to respond; a gentle 'Take your time — I'm here' reassures without pressuring.
Source: NCLEX-RN Test Plan: Psychosocial — Therapeutic Communication, Silence