Chapter 6

Question 1

Offering self

Answer 1

Making self available and showing interest and concern

Ex:
“I’ll sit with you for a while.”

“I’ll stay with you.”

Question 2

Active listening

Answer 2

Paying close attention to verbal and nonverbal communications, patterns of thinking, feelings, and behaviors

Face the patient; maintain eye contact; be open, alert, and patient; respond appropriately.

Question 3

Silence

Answer 3

absence of verbal remarks to allow patients to think and say more

Maintain eye contact; convey interest and concern in facial expressions.

Question 4

Empathy

Answer 4

Recognizing and acknowledging patients’ feelings

“I can hear how painful it is for you to talk about this.”

Question 5

Questioning

Answer 5

Using open-ended questions to achieve relevance and depth in discussion (not closed/yes-no questions)

“Who?”

“What?”

“Where?”

“What did you say?”

“What happened?”

“Tell me about it.”

Question 6

General leads

Answer 6

Using neutral expressions to encourage patients to continue talking

“Go on; I’m listening.”

“I hear what you are saying.”

Question 7

Restating

Answer 7

Repeating the exact words of patients to remind them of what they said, to let them know that they are heard

“You say you are going home soon.”

“Your mother wasn’t happy to see you?”

Question 8

Verbalizing the implied

Answer 8

Rephrasing patients’ words to highlight an underlying message

Patient: “There is nothing to do at home.”

Nurse: “It sounds as if you might be bored at home.”

Question 9

Clarification

Answer 9

Asking patients to restate, elaborate, or give examples of ideas or feelings

“What do you mean by ‘feeling sick inside’?”

“Give me an example of feeling ‘lost.’”

Question 10

Making observations

Answer 10

Commenting on what is seen or heard to encourage discussion

“You seem restless.”

“I noticed you had trouble making a decision about …”

Question 11

Presenting reality

Answer 11

Offering a view of what is real and what is not without arguing with the patient

“I know the voices are real to you, but I don’t hear them.”

“I don’t see it the same way.”

Question 12

Encouraging description of perception

Answer 12

Asking for patients’ views of their situations

“What do you think is happening to you right now?”

“What do you think is the issue with your wife?”

Question 13

Voicing doubt

Answer 13

Expressing uncertainty about the reality of patients’ perceptions and conclusions

“Is that the only way to interpret it?”

“What other conclusion could there be?”

Question 14

Placing an event in time or sequence

Answer 14

Asking for relationships among events

“When did you do this?”

“Then what happened?”

“What led up to …?”

“What is the connection between …?”

Question 15

Encouraging comparisons

Answer 15

Asking for similarities and differences among feelings, behaviors, and events

“How does this compare with the last time?”

“What is different about your feelings today?”

Question 16

Identifying themes

Answer 16

Asking patients to identify recurrent patterns in thoughts, feelings, and behaviors

“What do you do each time you argue with your wife?”

“What feeling do you get when you see your father?”

“Let’s see, so far you have said …”

Question 17

Summarizing

Answer 17

Reviewing main points and conclusions

“Let’s see, so far you have said …”

Question 18

Focusing

Answer 18

Pursuing a topic until its meaning or importance is clear

“Explain more about …”

“What bothers you about …?”

“What happens when you feel this way?”

Question 19

Interpreting

Answer 19

Providing a view of the meaning or importance of something

“It sounds as if this is very important to you.”

“You seem to get in trouble when you …”

Question 20

Encouraging evaluation

Answer 20

Asking for patients’ views of the meaning or importance of something

“So what does all this mean to you?”

“How serious is this for you?”

“How important is it to change this behavior?”

Question 21

Suggesting collaboration

Answer 21

Offering to help patients solve problems

“I can help you understand this better.”

“Let’s see if we can find an answer.”

Question 22

Encouraging goal setting

Answer 22

Asking patients to decide on the type of change needed

“What do you think needs to change?”

“What do you want to do differently?”

Question 23

Giving information

Answer 23

Providing information that will help patients make better choices

“I can tell you about your medicines.”

“There are self-help groups available.”

“What would be the advantage of trying …?”

“What might happen if you tried …?”

Question 24

Encouraging consideration of options

Answer 24

Asking patients to consider the pros and cons of possible options

“Which is the best alternative for you?”

“What would work best?”

Question 25

Encouraging decisions

Answer 25

Asking patients to make a choice among options Encouraging the formulation of a plan: Probing for step-by-step actions that will be needed

“What exactly will it take to carry out your plan?”

“What else do you need to do?”

Question 26

Rehearsing

Answer 26

Requesting a verbal description of what will be said or done

Question 27

Role playing

Answer 27

Practicing behaviors; the nurse plays a particular role

Question 28

Supportive confrontation

Answer 28

Acknowledging the difficulty in changing, but pushing for action

Question 29

Limit setting

Answer 29

Discouraging nonproductive feelings and behaviors, and encouraging productive ones

Question 30

Feedback

Answer 30

Pointing out specific behaviors and giving impressions of reactions

Question 31

Encouraging evaluation

Answer 31

Asking patients to evaluate their actions and the outcomes

Question 32

Reinforcement

Answer 32

Giving feedback on positive behaviors

ex:
“Tell me exactly what you will say to your wife on Friday.”

“I’ll play your wife. What do you want to say to me?”

“I know this isn’t easy to do, but I think you can do it.”

“It’s hard, but give it a try.”