Chapter 9: Therapeutic Communications Flashcards by Lani Manners

active listening

nurses focus, respond, and remember what the patient is saying verbally and nonverbally

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close ended questions

Questions that can be answered in short or single word responses

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cultural filters

in the process of socialization through which we listen to the world around us

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debriefing

a critical conversation and reflection regarding an experience that results in growth and learning

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double bind messages

-they are characterized by two or more mutually contradictory messages given by a person in power

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information communication technology

is a valuable tool for consumers and practicioners to access current psychiatric and medical breakthroughs, diagnoses, and treatment options

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mobile medical applications

-apps as tools to monitor, diagnose, treat, and communicate with patients

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nontheraputic communication

the tone of voice, emphasis on certain words, and the manner in which a person paces speech

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nonverbal behaviors

human actions that have the potential to form meaningful messages

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open ended questions

encourage patients to share information about experiences, perceptions, or responses to a situation

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patient centered

refers tl the patient as a full partner in care whose values, preferences, and needs are respected

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Telehealth technologies

include video conferencing, the internet, phone consultation and counseling, image transmission, and interactive video sessions

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therapeutic communication techniques

include words and actions that help to achieve health related goals

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verbal communication

consists of all the words a person speaks

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communicator

senders and recievers are both considered to be communicators

role is fluid
independent
“communication is not occurring if the receiver is not listening”

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message

content and the ideas that are being exchanged

also be nonverbal

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channel

the method by which the communication takes place

in person or phone

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feedback

the messaging takes place with constant feedback being given by both parties

feedback for one is the message for another

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encoding/decoding

individuals encode messages and send to the other and decode messages received from other

encode: develop
decode: determine meaning

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context

frames and influences our interactions

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environmental noise

serve as a barrier to interaction
disturbs message flow

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3 types of context

social
realtional
cultural

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social context

stated or unstated rules or norms that guide communicaiton

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relational context

interpersonal history
less scripted

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cultural context

influence that our culutural identities have on communication

3 types of environmental noise

physical physiological psychological

psychical noise

actual noise

physiological noise

biological factors EX: headache

psychological noise

factors within a persons mind such as not wanting to converse or being preoccupied about finances

guiding principles in communicaiton

clarity continuity non directive listening

clarity

ensures that the meaning of the message is accurately understood by both parties

continuity

promotes connections among ideas, feelings, events and themes

non directive listening

allows nurses to provide reflective and nonjudgemental feedback and thereby enables patients to clarify their thoughts

verbal communication

all words a person speaks

nonverbal

how you said it tone empasis pshycial apperance expressions posture

be aware of nonverbal cues

how you sit and stand

how is silence benefical

gives person a chance to collect thoughts and response

verbal messages can be called the

content

nonverbal messages are called the

process

double bind messages

mutually contradictory messages, usually given by a person in power

active listening

focus respond remember verbal and nonverbal

clarifying techniques

paraphrasing restating reflecting exploring

open ended questions

enourages patients to share info

close ended questions

yes no good for initial assessment non therapeutic if used outside of initial assessment

projective questions

"what if" help people articulate, explore, and identify thoughts and feelings

miracle question

"if you woke up tomorrow and a miracle happened that this issue affecting you went away..." goal setting question helps patient see future

broad openings

general allows patient to take control and give direction to where they want the conversation to go

"what are you thinking about" "what would you like to talk about" "where would you like to begin"

broad openings

giving recognition

acknowledging something in patient recognizing

"I noticed that you dressed and put make up on today" "you've really been participating in groups today" "it looks like you have put a lot into your journal assignments"

giving recognition

minimal enourgaement

paying attention to what they are saying

"yes" "I see" "go on"

minimal encouragement

offering self

offering of yourself/presence

"I would like to spend some time with you" "ill stay here and sit for awhile" "you seem upset, would you like to talk"

offering self

accepting

I understand what you are saying I can imagine how that made you feel

making observations

precursor to giving recognition saying what you see noticing behavior and acknowledge it

"you appear anxious" "I notice you are biting your lips" "you seem restless"

making observations

validate perceptions

validate that you understand

"you are smiling but I sense you are very angry with me" "it sounds like that was a really hard time for you, is that correct?"

validate perceptions

exploring

additional detail specific

"tell me more about that" "help me understand what that felt like" "id like to know more about that"

exploring

clarifying

helping to understand seeking understanding

"im not sure what you mean. could you tell me about that again" "did these feelings start after the incident happened or were you feeling this way before?" "give me an example of a time you thought everyone hated you"

clarifying 2nd one is also time and sequencing

"when did you do this?" "what led up to..." "how old were you when this happened" "what happened before"

event in time or sequence

focusing

you have broad topic but you want to focus on something more specific

"lets talk more about your relationship with your father" "what happens when you feel this way" "you've talked about many things, lets go back to..."

focusing

encouraging the development of a plan

you are giving patient the power to come up with a strategy on their own

"what could you do to let the anger out harmlessly?" "what do you think you could do next time you feel this way"

encouraging the development of a plan

suggesting collaboration

showing rapport and nurse is on patient side

"perhaps together we can discover what makes you anxious" "lets try to work through what you are feeling together"

sugesting collaboration

restatment

lets patient hear what they are saying allows for clarification

"I love my father but I hate him for what he did" - "you really have mixed feelings about your father because of the abuse"

restatement

summarizing

wrap it up

"during the past hour we have discussed" "so far we have talked about" "you have said"

summarizing

types of nontheraptic communication

excessive questioning giving approval or disapproval (do not pass judgment) giving advice (not our place to give) asking why (makes patient defensive)

other tactics to avoid

arguing, challenging giving false reassurance interpreting or speculating probing into sensitive areas pt doesn't want to talk abt "sell" patient on accepting treatment patient attacks criticizing other staff

barriers to communication

stereotype comments parroting (mimicking) changing topic when in depth on another disagreeing challenging

what should we do about touch

always ask and use sparingingly

eye contact is based on culture so we should not

use eye contact as a basis to assess for attentiveness

you can sit face to face with patient with or with out table but what should you always do

be eye level with patient

attending behaviors

kinetic communicaiton vocal quality proxemics

kinetic communication

nonverbal communication based on body movement

vocal quality is also called

paralanguage

proxemics

study of personal space

levels of proxemics

intimate personal social public