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Psych > 9. Communication and Therapeutic Relationship > Flashcards

9. Communication and Therapeutic Relationship Flashcards

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1
Q

understanding personal beliefs, thoughts, motivations, biases, and limitations

A

self-awareness

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2
Q

characteristics of self-awareness

A
  • introspective

- recognize the impact our biases have on others

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3
Q

parts of the biological self

A
  • physical characteristics
  • genetic makeup
  • chronic illness or unobservable physical disability
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4
Q

parts of the psychological self

A
  • psychological makeup
  • emotions
  • motivations
  • beliefs
  • traumatic experiences
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5
Q

parts of the social self

A
  • sociocultural values
  • cultural beliefs
  • patterns of communication
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6
Q

types of verbal communication

A
  • spoken word
  • underlying emotion
  • context
  • connotation
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7
Q

types of nonverbal communication

A
  • gestures
  • expressions
  • body language
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8
Q

ongoing process of interaction in which meaning emerges

A

therapeutic communication

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9
Q

proper nonverbal communication with a patient

A

SOLER

  • Sit squarely
  • Open posture
  • Leaning towards the pt
  • Eye contact
  • Relaxed
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10
Q

What is the nurse-patient relationship built on?

A

therapeutic communication (positive verbal and nonverbal)

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11
Q

therapeutic communication: focus

A

focus on the patient

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12
Q

therapeutic communication: attitude

A

professional and nonjudgemental

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13
Q

therapeutic communication: self-disclosure

A

rarely and with therapeutic purpose

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14
Q

therapeutic communication: advice

A

waste of time; help them explore options instead

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15
Q

therapeutic communication: social relationships

A

inappropriate

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16
Q

therapeutic communication: patient confidentiality

A

must be maintained

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17
Q

therapeutic communication: approach

A

at the level of the patient’s intellectual ability

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18
Q

therapeutic communication: goal

A

rationale reinterpretation of experiences

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19
Q

therapeutic communication: changing the subject

A

avoid; unless in the patient’s best interest

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20
Q

Reason for showing acceptance of patients

A

indicates to patient that they are being heard

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21
Q

gently (take baby steps) presenting a different reality of a situation

A

confrontation

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22
Q

verbal technique not used very much but can be used when the nurse wants to guide the patient towards other explanations

A

doubt

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23
Q

putting the patients words into your own words; helps the patient identify ideas or feelings

A

interpretation

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24
Q

monitoring a patients behavior or response to a certain situation

A

observation

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25
Q

Purpose of using open-ended statements

A

invites the pt to give more information

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26
Q

redirecting an idea or topic of conversation back to the patient for classification of important feelings, emotions, and experiences

A

reflection

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27
Q

repeating the main idea expressed by the patient back to them; lets them know that they communicated their thought or idea effectively

A

restatement

28
Q

gives the patient time to think and express themselves and lets them know you are listening

A

silence

29
Q

clarifying your understanding of a situation and the patient’s feelings about that situation

A

validation

30
Q

6 blocks to communication and why

A
  • advice: don’t want to give advice in case it goes wrong
  • agreement: doesn’t allow the pt to think about what they have said or give them a chance to change their mind
  • challenges: belittles them and injures self-esteem
  • reassurance: don’t want to tell them everything will be okay when you don’t know for sure
  • disapproval: belittles them and does not create a therapeutic relationship
  • asking “Why” questions: demands an explanation and implies criticism
31
Q

reason for developing rapport with patients

A

show that you care about them and are genuine

32
Q

reason for empathy

A

can help you understand what the patient is feeling (place yourself in their shoes)

33
Q

What are empathetic linkages

A

when you are talking to a patient about their feelings and you start to feel the same way (be aware of your own feelings)

34
Q

T/F: it is okay to hug a patient to show them you care

A

False; goes against professional boundaries (need to develop your own personal boundaries)

35
Q

4 body space zones

A
  • intimate
  • personal
  • social
  • public
36
Q

Purpose of defense mechanisms

A

prevents us from experiencing unpleasant feelings or being uncomfortable

37
Q

2 types of defense mechanisms

A
  • maladaptive

- adaptive

38
Q

refusing to acknowledge some painful aspect of reality or subjective experience that would be apparent to others

A

denial

39
Q

taking out frustrations, feelings, and impulses on people or objects that are less threatening

A

displacement

40
Q

experiencing a breakdown in the usually integrated functions of consciousness, memory, perception of self or the environment, or sensory and motor behavior

A

dissociation

41
Q

tending to perceive another individual as having more desirable qualities than he or she may actually have

A

idealization

42
Q

falsely attributing to another one’s own unacceptable feelings, impulses, or thoughts

A

projection

43
Q

explaining an unacceptable behavior or feeling in a rational or logical manner, avoiding the true reasons for the behavior

A

rationalization

44
Q

taking up the opposite behavior, thought, or feeling to one’s own unacceptable thoughts or feelings (usually occurs w/ repression)

A

reaction formation

45
Q

when a feeling is hidden and forced from the consciousness to the unconscious because it is seen as socially unacceptable

A

repression

46
Q

both harmful and helpful impulses are split off and integrated into the self or others; no room for ambiguity

A

splitting

47
Q

allows people to act out unacceptable impulses by converting them to a more acceptable form

A

sublimation

48
Q

intentionally avoiding thinking about disturbing problems, wishes, feelings, or experiences

A

suppression

49
Q

trying to make up for what one feels are inappropriate thoughts, feelings, or behaviors

A

undoing

50
Q

writing a verbatim transcript of an interaction

A

process recording

51
Q

purpose of process recording

A

help us distinguish pt’s thoughts and feelings through a conversation

52
Q

3 things to look for in a process recording

A
  • symbolism
  • content themes
  • communication blocks
53
Q

use of a word or phrase to represent an object, event, or feeling

A

symbolism

54
Q

concerns or feelings verbally expressed repeatedly in several different ways

A

content themes

55
Q

identified by topic changes that either the nurse or the patient makes; changed for various reasons

A

communication blocks

56
Q

phase with the first patient meeting; the relationship is tested and information is gathered about the patient with confidentiality maintained

A

orientation phase

57
Q

phase where problems are identified and problem solving occurs

A

working phase

58
Q

phase where problems are resolved and the relationship ends

A

resolution phase

59
Q

phase where you obtain assessment and initial data about the pt and explore your feelings about interacting with them

A

pre-interaction phase

60
Q

redirection of feelings and attitudes onto the nurse

A

transference

61
Q

when the nurse redirects their feelings and attitudes onto the patient

A

countertransference

62
Q

identifying patient’s stage of change and using patient decision-making abilities to help them make a change

A

motivational interviewing

63
Q

8 features of motivational interviewing

A
  • openness and collaboration w/ patient’s expertise
  • proficiency in patient centered counseling (including empathy)
  • recognition of key aspects of patient speech
  • eliciting and strengthening patient change talk
  • rolling w/ resistance
  • negotiating change plans
  • consolidating patient communication
  • switching flexibility between MI and other interventions
64
Q

transitioning from one relationship to another

A

transitional relationship model

65
Q

describe a non therapeutic relationship

A

feelings of frustration -> grappling and struggling to reach common ground -> mutual withdrawal

66
Q

phases of a deteriorating relationship

A
  • withholding phase: nurse is perceived as withholding nursing support
  • avoiding and ignoring phase: pt begins avoiding nurse and perceives nurse is avoiding them; nurse ignores pt’s request for help
  • struggling to make sense phase: pt struggles and tries to make sense of relationship; end as enemies

Psych (17 decks)

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