When a client discusses personal topics in therapy and becomes upset, which approach is recommended?

• A. Acknowledge feelings and use concrete, hands-on tasks
• B. Dismiss feelings
• C. Switch to theory-heavy discussion
• D. Increase medication dosage

Answer: (B)

When a client discusses personal topics in therapy and becomes upset, respond with validation and grounding. Acknowledge what the client is feeling and reflect it back in a supportive way. Then offer a concrete, hands-on task or activity to help regulate arousal and bring focus back to meaningful engagement. This approach helps maintain safety, preserves the therapeutic alliance, and provides a tangible way to cope in the moment, which is central to occupational therapy’s goal of enabling participation in daily life.

Dismissing feelings sends the message that the client’s experiences aren’t important, which can damage trust and make regulation harder. Shifting to theory-heavy discussion during distress can be overwhelming and may derail progress. Increasing medication dosage is a medical decision and doesn’t address in-session emotion regulation or functional engagement.