A hospitalized patient with depression isolates in their room, refuses meals, and states, “I don’t have the energy to do anything.” Which intervention is most therapeutic?

Question

BlackTom AI · Accepted Answer

Behavioral activation—encouraging gradual participation in structured activities—directly addresses the core symptoms of depression such as anergia, social withdrawal, and loss of interest. It is an evidence-based approach that uses small, achievable steps to rebuild routine, increase mastery and pleasure, and counteract avoidance that reinforces low mood.

Relevant knowledge points and concepts:
- Major depressive symptoms often include low energy, social withdrawal, and decreased motivation. These perpetuate each other through negative reinforcement (staying in bed reduces immediate effort but maintains depression).
- Behavioral activation and graded task assignment help patients regain functioning by scheduling brief, manageable activities that are progressively increased.
- Therapeutic milieu and group activities provide social support, normalization, and opportunities for positive reinforcement.

Step-by-step reasoning:
1. Patient reports low energy and isolates—this is typical of depression and increases risk of worsening mood and neglect.
2. For safety, assess for suicidal ideation and medical issues (if present, intervene). Assuming medical stability, the therapeutic goal is to re-engage the patient.
3. Introduce a graded plan: start with brief, low-demand activities (e.g., sit in a common area for 10 minutes, have a snack with staff, then attend a short group). Reinforce successes and adjust pacing.
4. Gradual participation reduces the anticipatory anxiety and fatigue barrier, increases reinforcement, and builds stamina over time.

Why the correct answer is correct:
- Encouraging gradual participation is therapeutic because it is realistic, nonshaming, and empirically supported to improve mood and functioning.

Why other options are incorrect:
- Allowing the patient to stay in bed prolongs isolation and deconditioning, worsening depression.
- Assigning high-energy activities is unrealistic, risks failure, and can increase shame.
- Telling the patient to “push through” is dismissive, invalidates feelings, and is unlikely to motivate sustained engagement.

Conclusion: The most therapeutic intervention is to encourage gradual participation in group activities, which matches the provided correct answer.

A hospitalized patient with depression isolates in their room, refuses meals, and states, “I don’t have the energy to do anything.” Which intervention is most therapeutic?单项选择题

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