Exam 1: Therapeutic Communication Flashcards
Communication
exchange of information
Two types of communication
- Verbal
- Nonverbal
Verbal communication content:
literal words spoken
Verbal communication context:
Context: environment, circumstances, situation in which communication occurs
Nonverbal communication process:
Process: all messages used to give meaning, context to message
Nonverbal communication
Congruent or incongruent messages
Goals of therapeutic communication
Establish therapeutic nurse–client relationship
Identify the most important client’s concerns; assess client’s perceptions
Facilitate client’s expression of emotions
Recognize client’s needs
Implement interventions to address client’s needs
Guide client toward acceptable solutions
Distance zones: Intimate
0-18inch
Distance zones: Personal
Personal (18–36 in)
Distance zones: Social
Social (4–12 ft)
Distance zones: Public
Public (12–25 ft)
What distance is best for therapeutic communication?
Therapeutic communication: most comfortable when nurse and patient are 3 to 6 ft apart
Touch in therapeutic communication
Can be possible invasion of intimate and personal space
The nurse must evaluate use of touch based on the client’s preferences, history, and needs.
Nurse may find touch supportive, client may NOT*
Active listening in therapeutic communication
Active listening (concentrating exclusively on what patient says)
Active Observation in therapeutic communication
Active observation (watching nonverbal actions as speaker communicates)
Active Listening and Active Observation help the nurse with _____in therapeutic communication
- Recognize the most important issue
- Know what questions to ask
- Objectively respond to message in a concrete manner
Techniques for verbal communication:
- Exploring, restating, reflecting, clarifying
- Some promote discussion of feelings or concerns in more depth
- Feedback via making an observation or presenting reality
Nontherapeutic techniques to avoid:
Advising, belittling, challenging, probing, reassuring, Why questions
Overt signals or cues
Overt (clear, direct statements)
Covert signals or cues
Covert (vague, indirect messages)
Nonverbal communication includes
Facial expression
Body language
Closed body position
Open posture
Vocal cues
Eye contact
Silence
Spirituality in communication
Self-awareness of own spiritual beliefs
Need for objectivity and nonjudgmental attitude about client’s beliefs
Cultural considerations in communication
Cultural assessment
Use of a translator who can retain original intent without inserting biases
Nurse must understand differences in how various cultures communicate.
Goals for establishing a therapeutic session:
Establishing rapport
Actively listening
Gaining in-depth understanding of client’s perception of issue
Being empathetic
Exploring client’s thoughts and feelings
Facilitating client’s expression of thoughts and feelings
Guide client in developing problem-solving skills
Promoting client’s evaluation of solutions
How to initiate a therapeutic communication session
- Introduction
- Establishment of contract for relationship
- Identification of major concern
What is involved in identification of major concern:
- Nondirective role (broad openings, open-ended questions)
- Directive role (direct yes-or-no questions; usually for clients with suicidal thoughts, in crisis, or who are out of touch with reality)
Important tips for a good therapeutic session:
Asking for clarification
Addressing client’s avoidance of anxiety-producing topic
Guiding the client in problem-solving and change
Help the client explore possibilities
Client’s participation is key.
Avoid inserting own beliefs
Expression of positive and negative feelings/ideas in an open, honest, direct way
Calm, specific, factual statements
Focus on “I” statements
What is the first step toward improving communication?
Awareness of own communication is the first step toward improving communication.
Ask for feedback from colleagues.
Examine own communication skills.
