Which statement is an example of reflection?

Correct Answer: B

Rationale: Reflection is a communication technique where one person mirrors or restates the content or emotion expressed by another person to demonstrate understanding and encourage further exploration. The goal is to capture the essence of what was said or felt, often paraphrasing or summarizing it to validate the speaker’s experience. **Why B is correct:** "So you are saying that life has no meaning" is a clear example of reflection because it restates or paraphrases an underlying message a speaker might have conveyed. It captures a deeper, potentially implicit meaning and reflects it back, allowing the speaker to confirm, clarify, or expand on their thoughts. This technique is common in active listening and therapeutic communication, where the responder aims to engage with the speaker’s perspective rather than introduce their own interpretations or feelings. **Why A is incorrect:** "I think this feeling will pass" is not reflection because it introduces the responder’s own perspective rather than mirroring the speaker’s words or emotions. This statement offers reassurance or prediction (a form of interpretation or advice), which shifts focus away from the speaker’s experience. Reflection requires staying neutral and closely tied to the speaker’s original expression, which this statement does not do. **Why C is incorrect:** "I'm not sure I understand what you mean" is a request for clarification rather than reflection. While it shows engagement, it does not restate or summarize the speaker’s words or emotions. Instead, it signals confusion and asks the speaker to rephrase or elaborate. Reflection, by contrast, involves actively demonstrating understanding by echoing the speaker’s message, not expressing uncertainty about it. **Why D is incorrect:** "You look sad" is an observation or interpretation of the speaker’s emotional state, not a reflection of their expressed words or feelings. It may be an attempt at empathy, but reflection requires explicitly tying the response to the speaker’s own statements. Without referencing something the speaker said (e.g., "You sound upset when you talk about this"), it remains an external observation rather than a mirrored reflection. In summary, reflection hinges on accurately and neutrally restating the speaker’s message or emotions, which only B accomplishes. The other choices either introduce new perspectives, seek clarification, or make external observations, all of which deviate from the core purpose of reflection in communication.

Correct Answer: D

Rationale: Asking 'why' questions is not considered a therapeutic technique in patient-centered communication as it can make patients feel defensive or judged. 'Why' questions may imply criticism or put the patient on the spot, potentially hindering open and honest communication. Instead, focusing on open-ended questions that encourage patients to express their feelings and thoughts without feeling judged or interrogated is more conducive to therapeutic communication.

Correct Answer: A

Rationale: Carolina's best response is **A: *"That sounds exciting, would you be willing to visit and show me the app?"*** because it demonstrates openness, curiosity, and a patient-centered approach. By validating the patient’s interest in the app, Carolina fosters trust and keeps communication lines open. This response allows her to assess the app’s credibility, discuss its integration with their ongoing therapy, and ensure the patient isn’t abandoning evidence-based care prematurely. It also avoids defensiveness, which could alienate the patient. A collaborative approach encourages the patient to remain engaged while allowing Carolina to provide professional guidance on whether the app complements or conflicts with their treatment plan. **B: *"At this time, there is no real evidence that the app can replace our therapy."*** is problematic because it dismisses the patient’s autonomy and enthusiasm without exploration. While it may be true that many apps lack rigorous evidence, outright rejection can make the patient defensive. A better approach would involve discussing research together, evaluating the app's merits, and addressing gaps in its effectiveness rather than issuing a blanket dismissal. This response risks shutting down dialogue and may push the patient further away from professional support. **C: *"I am not sure that is a good idea right now, we are so close to progress."*** assumes that the therapist's perspective on progress outweighs the patient’s agency. While the concern is valid—abruptly stopping therapy can disrupt gains—this phrasing centers Carolina’s agenda rather than the patient’s needs. It could come across as manipulative ("we’re *so close*") rather than collaborative. A more effective approach would be acknowledging the patient’s autonomy while discussing potential risks of discontinuing sessions. **D: *"Why would you think that is a better option than meeting with me?"*** is the least constructive, as it frames the question confrontationally. This puts the patient in a position to justify their choice defensively, which could damage rapport. It implies that Carolina’s ego is more important than understanding the patient’s perspective. Even if the app is inadequate, this response fails to guide the patient toward an informed decision, instead breeding resentment or withdrawal. In summary, **A** succeeds because it balances professional guidance with respect for the patient’s choices, fostering a partnership rather than authority-based compliance. The incorrect options either dismiss, manipulate, or challenge the patient in ways that undermine therapeutic trust. Effective responses in such scenarios prioritize curiosity, collaboration, and patient empowerment while ensuring clinical oversight.

Correct Answer: A

Rationale: Choice A, 'Hitting me when you are angry is unacceptable,' demonstrates a well-structured attempt at limit setting because it clearly defines the unacceptable behavior without ambiguity. This statement sets a clear boundary and clearly communicates the consequence for the behavior. In contrast, choices B, C, and D are less effective in setting limits as they are either vague expectations or commands without specific consequences for crossing the limit.

Correct Answer: D

Rationale: Children with ADHD often struggle with sustained attention, impulsivity, and hyperactivity, making it essential to select activities that align with their neurological needs while minimizing frustration. Tennis (D) is the most appropriate choice because it combines physical exertion, structured rules, and intermittent bursts of focused activity, which are well-suited for ADHD. Physical exercise, such as tennis, has been shown to improve executive function, attention, and impulse control by increasing dopamine and norepinephrine levels—neurotransmitters often dysregulated in ADHD. The game’s fast-paced nature provides immediate feedback and rewards, keeping the child engaged without requiring prolonged static focus. Additionally, the social and competitive aspects can reinforce positive behavior and teamwork. Reading an adventure novel (A) is less ideal because it demands sustained silent focus, a challenge for children with ADHD who may struggle with attention spans and sitting still. While some children with ADHD might enjoy stories, the lack of physical engagement and delayed gratification (e.g., waiting for plot developments) can lead to frustration or disengagement. Monopoly (B) is problematic due to its lengthy playtime, complex rules, and turn-based structure, which may exacerbate impulsivity (e.g., acting out of turn) or boredom during waiting periods. The game’s reliance on strategic planning and delayed rewards can also be overwhelming for a child with executive function difficulties. Checkers (C), while simpler than Monopoly, still requires sustained attention and strategic thinking, which can be taxing. The sedentary nature of the game may not accommodate the child’s need for movement, potentially leading to restlessness or impulsivity, such as making hasty moves without planning. Tennis stands out as the best option because it channels the child’s energy productively, provides sensory and motor stimulation, and aligns with evidence-based interventions for ADHD, such as incorporating physical activity into daily routines. The other choices, while potentially enjoyable for some, fail to address the core challenges of ADHD as effectively.