CH5 Therapeutic Relationships

Question 0

Which 13 behaviors should the nurse exhibit to help build trust with the client?

Answer 0

1) Caring
2) Consistency
3) Openness
4) Objectivity
5) Approachability
6) Honesty
7) Interest
8) Keeping Promises
9) Listening
10) Respect
11) Suggesting without Telling
12) Treating the client as a human being
13) Understanding

Question 1

Define Congruence

Answer 1

Congruence - When words and actions match. Helps your PT to build trust in you because they know you will follow through with what you tell them.

Question 2

What are the 6 components of a Therapeutic Relationship?

Answer 2

1) Trust
2) Genuine Interest
3) Empathy
4) Acceptance
5) Positive Regard
6) Self-Awareness & Therapeutic Use of Self

Question 3

Define Genuine Interest

Answer 3

Genuine Interest - Truly paying attention to the client and caring about what he or she is saying, which is only possible when the nurse is comfortable with himself or herself and aware of his or her strengths and limitations.

Question 4

Define Empathy

Answer 4

Empathy - The ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client.

Question 5

Define Acceptance

Answer 5

Acceptance - Avoiding judgements of the person, no matter what the behavior.

Question 6

Define Positive Regard

Answer 6

Positive Regard - Unconditional, non-judge mental attitude that implies respect for the person.

Question 7

Define Values

Answer 7

Values - Abstract standards that give a person a sense of right and wrong and establish a code of conduct for living.

Question 8

What are the 3 steps of the Values Clarification Process?

Answer 8

1) Choosing - When the person considers a range of possibilities and chooses the value that feels right.
2) Prizing - When the person considers the value, cherishes it, and publicly attaches it to himself.
3) Acting - When the person puts the value into action.

Question 9

What are the 3 components of Self-Awareness?

Answer 9

1) Values
2) Beliefs
3) Attitudes

Question 10

Define Beliefs

Answer 10

Beliefs - Ideas that one holds to be true

Question 11

Define Attitudes

Answer 11

Attitudes - General feelings or a frame of reference around which a person organizes knowledge about the world.

Question 12

Define Therapeutic Use of Self

Answer 12

Therapeutic Use of Self - When nurses use themselves as a therapeutic tool to establish the therapeutic relationship with clients to help clients grow, change and heal.

Question 13

Describe the 4 quadrants of the Johari Window

Answer 13

1) Quadrant 1 (Open/Public self-qualities) - Qualities one knows about self and others also know.
2) Quadrant 2 (Blind/Unaware self-qualities) - Qualities known only to others.
3) Quadrant 3 (Hidden/Private self-qualities) - Qualities known only to oneself.
4) Quadrant 4 (Unknown qualities) - An empty quadrant to symbolize qualities as yet undiscovered by oneself or others.

Question 14

Define Preconceptions

Answer 14

Preconceptions - The way one person expects another to behave or speak; Often a roadblock to the formation of an authentic relationship.

Question 15

What are the 4 “Patterns of Knowing” in Nursing, identified by Carper in 1978?

Answer 15

1) Empirical Knowing - Obtained front he science of nursing.
2) Personal Knowing - Obtained from life experiences.
3) Ethical Knowing - Obtained from the moral knowledge of nursing.
4) Aesthetic Knowing - Obtained from the art of nursing.

Question 16

Define Unknowing as it relates to the “Patterns of Knowing” in Nursing.

Answer 16

Unknowing - When the nurse admits that she does not know the client or the client’s subjective world. This opens the way for a truly authentic encounter. he nurse in a state of unknowing is open to seeing and hearing the client’s views without imposing any of his or her values or viewpoints.

Question 17

What are the 3 major categories of relationships?

Answer 17

1) Social
2) Intimate
3) Therapeutic

Question 18

What are the 3 phases of the nurse-client relationship?

Answer 18

1) Orientation - Begins when the nurse and client meet and ends when the client begins to identify problems to examine.
2) Working - Begins when the client begins to identify problems to examine and ends when the problem is resolved.
3) Termination (aka Resolution) - Begins when the problems are resolved and ends when the relationship is ended.

Question 19

Define Self Disclosure

Answer 19

Self Disclosure - Revealing personal information such as biographical information and personal ideas, thoughts, and feelings about oneself to the client.

Question 20

What are the 6 goals of the Orientation Phase of the Therapeutic Relationship?

Answer 20

1) Meeting of the nurse and client
2) Establishment of roles
3) Discussion of purposes and parameters of future meetings
4) Clarification of expectations
5) Identification of client’s problem
6) Establishment of Nurse-client contracts/confidentiality, duty to to warn, and self-disclosure

Question 21

What are the 11 specific tasks of the Working a phase of the Therapeutic Relationship?

Answer 21

1) Promoting independence
2) Promoting a positive self-concept
3) Providing opportunities for the client to practice new behaviors
4) Exploring perceptions of reality
5) Evaluating progress and redefining goals as appropriate
6) Encouraging verbalizations of feelings
7) Facilitating behavioral change
8) Maintaining the relationship
9) Gathering more data
10) Working through resistance
11) Developing positive coping mechanisms

Question 22

Define Transference and Countertransference

Answer 22

1) Transference - Occurs when the client displaces onto the therapist attitudes and feelings that the client originally experienced in other relationships.
1) Countertransference - Occurs when the therapist displaces onto the client attitudes and feelings from his or her past.

Question 23

What are the 2 sub-phases of the Working Phase of the Therapeutic Relationship? Describe both.

Answer 23

1) Problem Identification
2) Exploitation - When the nurse guides the client to examine feelings and responses and to develop better coping skills and a more positive self image; This encourages behavior change and develops independence.

Question 24

What are the 4 Roles of the nurse in a Therapeutic Relationship?

Answer 24

1) Teacher -
2) Caregiver - Used to build trust, explore feelings, assist the client in problem solving, and help the client meet psychosocial needs.
3) Advocate - The nurse informs the client and then supports him or her in whatever decision he or she makes.
4) Parent Surrogate - When the relationship goes from being adult-adult to adult-child.