Communication Flashcards
What is therapeutic communication?
Verbal and non-verbal communication between practioner/client - helps client reduce emotional distress, is supportive, educates, gives feedback, brings balance to perspectives.
What are key areas of effective therapeutic communication?
- Empathy
- Trust
- Using open-ended questions
- Silences
- Self-disclosure
- Advice giving
- Reflection
List barriers to practitioner communication:
- Desk in between practitioner/client
- Windows - behind or side of practitioner - have back to window
- Unpracticed verbal/non-verbal communication
What is empathy?
Understanding a situation from the perspective of someone else (client). Understand the emotions of someone else.
List 4 x techniques of effective listening:
- Clarification - clarify you understand
- Reflection - show’s interest/no judgement
- Paraphrasing - allows disclosure/builds trust/client hears own story
- Summarising - draws conclusions/encapsulates main ideas/issuers, outlines client perspectives
List 6 x barriers to effective communication:
- Variation of cultural norms i.e. personal space/gestures
- Language barriers
- Assumption of sexual orientation/gender roles i.e. do you have a girlfriend (asked to boy)
- Gender stereotypes - problematic
- Religion/spirituality - be impartial
- Social class - be aware of class bias
List 6 x barriers to effective communication:
- Variation of cultural norms i.e. personal space/gestures, beliefs, values, nonverbal cues
- Language barriers
- Assumption of sexual orientation/gender roles i.e. do you have a girlfriend (asked to boy)
- Gender differences/stereotypes - problematic
- Religion/spirituality - be impartial
- Social class - be aware of class bias
- Role uncertainty by client
- Sensory overload
- Tone/pitch/volume
- Word choice - pitch to client
- Physical appearance - be aware of biases
Describe optimal non-verbal behaviour by clinician:
Sit squarely, open Lean towards client slightly Smile Use appropriate eye contact (4-5 sec duration at a time) Relax body
Therapeutic communication should be?
Professional
Patient-centred
Goal directed
Scientifically based
Communication mistakes to avoid:
- Why questions - criticism/defensive response
- Value judgements - client feels bad/disengages
- Minimising patient feelings - no empathy
- False assurance - belittles patient - I know how you feel
- Too many questions - confusion
- Disapproving/disagreeing - defensive response
7, Premature advice - assumption practitioner all knowing - Approval/agreeing - judgement (good, therefore change = bad)
- Changing subject - disinterest
How to communicate therapeutically:
- Recognition to patient
- Broad openings - anything you’d like to discuss
- Offer lead - mm, ok, go on…
- Client to suggest plan
- Client describe what they are experiencing* How does that make you feel - client to evaluate
- Paraphrasing/reflecting back/re-stating
- Suggesting collaboration
What does communication include:
words gestures expressions tone body language eye contact
Communication is a method of passing on what?
Information
Meaning/context
What are important communciation skills?
Open-ended enquiry Active listening Reflective practice Empathy Caring behaviours
What are the elements of effective communication?
Tone, pitch volume, speed
Non-verbal communciation
What does proxemics mean?
It’s the amount of personal space people need.
Which factors affect communication?
Perceptions/interpretation impacted by:
- ethnic background
- level of education
- socioeconomic factors
- age
- life experience
Other factors:
- time of day
- mental health
- current life events
What are the four levels of communication?
- Intrapersonal (self)
- Interpersonal - two people
- Small group discussion (more than one other)
- Organisational communication
What is the three-step framework for active listening?
- Restatement - re-state
- Reflection - reflect back
- Clarification - can do this, or can do that - client chooses
Name two active listening questions:
- What are the priorities?
2. What would most benefit the client?
Where are anger, fear, and sadness seen in?
eyes
Where are happiness and disgust seen?
mouth
With proxemics, what are the four space zones?
Intimate
Personal
Social
Public
Name the three types of touch in the clinical setting:
- Procedural/instrumental - moving clinet/drawing blood
- Expressive/caring - hand shoulder
- Therapeutic - massage/physio work
What are the physiological responses when catecholamines are released in response to laughter?
- Increased alertness
- Increased problem solving
- dilated blood vessels
- Increased heart rate
- Increased HDL (good) cholesterol
- Reduced risk of heart disease
- Increased O2 in lungs
- Reduced CO2 in lungs
- Reduced mention in muscles
- Reduced stress hormones
Name four types of conflict:
- Personal conflict - internal conflict / interrole conflict
- Interpersonal conflict - between two people or more
- Intragroup conflict - issues between members of group
- Intergroup conflict - issues between groups - depts/organisations
What are 4 factors that influence conflict outcomes?
- The issue
- Cooperation by parties
- Power position of parties
- Communication skills of those involved
When may conflict resolution be hard?
When there is a principle involved.
List 6 x strategies used to manage conflict:
- avoidance - dodge conflict/passive-positive if angry/let go minor conflicts
- accommodation - good short-term, long-term = frustration - maintain harmony
- competition - aggressive method red. conflict - power driven
- compromise - 1/2 between accomm/competition
- collaboration (preferred option!) - win win solutions - mutual goals, problem solving, strong relationships
- Mediation - neutral party req. when resolution unsuccessful
Evaluate conflict to decide best resolution tool.
What are the three T’s in Treatment?
- Theory - scientific base
- Technique - how to tools
- Therapeutic alliance - apply theory/technique
What is the purpose of a biomedical interview?
Identify disease/dysfunction and determine req. medical intervention (2 x F’s - find it, fix it)
Describe common steps to biomedical interviews:
Medical history
Open-ended questions
Closed-ended questions - fine-tune info rec.
Doc prompts description of symptoms
List problems with biomedical interviews:
- clinician interruption
- diagnostic info withheld client
- assumptions - 1st wave info
- social history not included - just biomedical info
What are the positive results of client-centered interviews?
- Positive outcomes
- Gained trust
- Improved adherence
- Increased personal empowerment
- improved client satisfaction
- strong rapport client/clinician
What is the main way clinicians learn about clients with client-centered interviews?
Client’s storytelling
How do you avoid ‘doorknob’ discussions during client-centered interviews?
Ask - is there anything else you’d like to discuss.
Set aside time for this.
According to arther Kleinman, what is the explanatory model and why is it essential to client-centered interviews?
Belief systems used to understand an individual’s health. Gives clinician insight into client perceptions of health/issues. Gives context.
Q to client - what do you think is wrong?
What is Boyle’s recommended sequence for client-centered interviews?
Invite - I’m interested in knowing something about you - ‘see’ client - what brings you here today?
Listen - attentive listening - process, reflect, ask open-ended questions
Summarise in statements. Closed-ended questions to clarify info as req.
With the Yale approach to communication/persuasion, what is the breakdown of communication?
- Who - source (communicator)
- What - the message
- Whom - audience
According to the Yale approach to communication/persuasion, what are the 4 steps to persuasion?
- Attention = audience
- Comprehension
- Acceptance
- Retention
According to the Yale approach to communication/persuasion, what are factors about the communicator that increase the persuasion of the message?
- more greatly influenced by those we know/attracted to
- If communicator is an expert - skills to persuade
- Communicator holds power open to us - more influential
Why does who the communicator is, affect the receipt of the message?
- more likable/similar - more open to message
- if more believable - more persuasive
- the closer ideas are to existing ideas, more likely to adopt
- timing affects acceptance of info
