LECTURE 3: Core Dimensions of Helping

Question 1

storytelling in nursing practice: patient telling their story

Answer 1

• identifies strengths, capabilities, and presenting concerns
• creates an image of daily activities, family relations, health promotion good/bad
• enables faith, hope, trust, getting well, and visualizing a future

Question 2

Carl Rogers (1902-1987)

Answer 2

Carl Rogers made the person-centred therapy model
- congruence
- unconditional positive regard (self-worth, no judgement)
- empathy
congruence creates less space between self-image and ideal-self

Question 3

core dimensions of helping: responsive dimensions

Answer 3

• respect
• genuineness
• concreteness
• empathic understanding

Question 4

core dimensions of helping: action dimensions

Answer 4

• confrontation
• self-disclosure
• immediacy
• catharsis

Question 5

Genuineness

Answer 5

the presentation of one’s thoughts and feelings both verbally and nonverbally
- openness, honesty, sincerity

Question 6

Concreteness, and the three functions

Answer 6

• specific, not abstract
• avoid vagueness
  1. keeps the nurse’s response close to client’s feelings and experiences
  2. fosters accuracy of understanding by the nurse
  3. encourages client to attend to specific problem areas

Question 7

confrontation, and the three categories

Answer 7

• invitation to examine incongruities between feelings, beliefs, attitudes, and behaviours
• allows the other to grow
• not limited to negative aspects of the client
  1. between self concept and self ideal
  2. between verbal self expression and non verbal behaviour
  3. between clients expressed opinion of themself and the nurse’s expressed opinion of them

Question 8

confrontation - timing in relationship

Answer 8

• trust level, timing, patient’s stress level

early in the relationship
- be non-threatening, point out patient’s strengths

Question 9

immediacy

Answer 9

• focusing on what’s occurring in the immediate relationship (here and now)
• involves sensitivity to the client’s feelings and willingness to deal with these feelings

Question 10

self-disclosure

Answer 10

• nurse shares personal information about experiences, attitudes, or feelings
• useful to demonstrate understanding and increase trust
  BEWARE:
• self-disclosure needs to be related to the patient’s situation, don’t disclose to meet your own personal needs

Question 11

emotional catharsis

Answer 11

• catharsis occurs when the patient is encouraged to talk about things that are most bothersome
• brings feelings, fears, and experiences out into the open to be discussed/examined by the nurse

Question 12

empathy

Answer 12

capacity to share and understand other’s internal states, defining attributes (Wiseman, 1996):
1. see the world as others see it
2. understand another’s feelings
3. non-judgemental
4. communicate the understanding

Question 13

empathy: 3 stages

Answer 13

1. self-transposition
2. crossing-over
3. getting “self” back

Question 14

empathy: preverbal vs. verbal

Answer 14

preverbal: mental process where the nurse shifts from their world into the client’s
verbal: accurately & specifically reflecting your understanding