一位 25 歲重度憂鬱症病人住院，病人表示：「我是個失敗者，沒人關心我。」護理師哪種回覆最具治療性？
A 25-year-old client is admitted for major depressive disorder. The client says, 'I am a failure and nobody cares about me.' Which response by the nurse is the most therapeutic?
- ALet's focus on your strengths instead of your failures.讓我們專注於你的優勢而非失敗。
- BWhy do you feel like a failure?你為什麼會有失敗的感覺？
- CI hear that you are feeling very lonely and worthless right now.✓ 正解我聽到你現在感到非常孤單和無價值。
- DYou have many people who care about you.有很多人在乎你。
治療性溝通強調「反映感受」（Reflection of feelings）。C 選項透過同理心讓病人感到被接納，不帶偏見地反映其內在經驗。D 選項為論辯式的否定；B 使用「為什麼」會導致病人被迫解釋防禦；A 則是過早導向正面思考，未處理病人當下的痛苦感。
The most therapeutic response is to reflect the client's feelings, validating their emotional experience without judgment or immediate problem-solving. By acknowledging the client's sense of loneliness and worthlessness, the nurse fosters trust and encourages further expression. Responses that challenge feelings, ask 'why,' or prematurely shift focus to strengths may invalidate the client's current distress.
美國護理教育極度重視溝通技巧的「治療性距離」，台灣臨床常因醫護比過高，護理師較少有時間進行深度心理反映。