Relationship Development & Therapeutic Communication Flashcards

1
Q

What is the instrument for delivery of care to clients in need of psychosocial intervention? What are the tools of psychosocial intervention?

A

Therapeutic use of self - The instrument of delivery of care to clients in need of psychosocial intervention is the therapeutic use of self.
Interpersonal communication - interpersonal communication techniques are the tools of psychosocial intervention.

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2
Q

Phases of a Therapeutic Nurse-Client Relationship

A

1) Pre-interaction Phase
- Obtain information about the client from chart, significant others, or other health team members.
- Examine one’s own feelings, fear, and anxieties about working with a particular client.
2) Orientation (introductory) phase
- Create an environment for trust and rapport.
- Establish contract for intervention
- Gather assessment data
- Identify client’s strengths and limitations
- Formulate nursing diagnoses
- Set mutually agreeable goals
- Develop a realistic plan of action
- Explore feelings of both client and nurse
3) Working phase
- Maintain trust and rapport
- Promote client’s insight and perception of reality
- Use problem-solving model to work toward achievement of
established goals
- Overcome resistance behaviors
- Continuously evaluate progress toward goal attainment
- Transference: occurs when the client unconsciously displaces or transfers to the nurse feelings formed toward a person from the past.
- Countertransference: refers to the nurses behavioral and emotional response to the client
4) Termination phase
- Progress has been made toward attainment of goals
- A plan of action for more adaptive coping with future stressful situations has been established
- Feelings about termination of the relationship are recognized and explored.

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3
Q

Therapeutic Communication Techniques (Define): Using silence, Accepting, and Giving recognition

A

Using silence: allows client to take control of the discussion, if they so desire

Accepting: conveys positive regard

Giving recognition: acknowledging, indicating awareness

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4
Q

Therapeutic Communication Techniques (Define): Offering self, Giving broad openings, and Offering general leads

A

Offering self: making oneself available

Giving broad openings: allows client to select the topic

Offering general leads: encourages client to continue

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5
Q

Therapeutic Communication Techniques (Define): Placing the event in time or sequence, Making observations, Encouraging description of perceptions

A

Placing the event in time or sequence: clarifies the relationship of events in time

Making observations: verbalizing what is observed or perceived

Encouraging description of perceptions: asking client to verbalize what is being perceived

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6
Q

Therapeutic Communication Techniques (Define): Encouraging comparison, Restating, and Reflecting

A

Encouraging comparison: Asking client to compare similarities and differences in ideas, experiences, or interpersonal relationships

Restating: lets client know whether an expressed statement as been understood

Reflecting: directs questions or feelings back to client so that they may be recognized and accepted (“sounds like you may want to ___)

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7
Q

Therapeutic Communication Techniques (Define): Focusing, Exploring, Seeking clarification and validation, and Presenting reality

A

Focusing: taking notice of a single idea or even a single word

Exploring: delving further into a subject, idea, experience, or relationship

Seeking clarification and validation: striving to explain what is vague and searching for mutual understanding

Presenting reality: clarifying misconceptions that the client may be expressing

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8
Q

Therapeutic Communication Techniques (Define): Voicing doubt, Verbalizing the implied, Attempting to translate words into feelings, and Formulating plan of action

A

Voicing doubt: Expressing uncertainty as to the reality of client’s perception

Verbalizing the implied: Putting into words what client has only implied

Attempting to translate words into feelings: Putting into words the feelings the client has expressed only indirectly

Formulating plan of action: Striving to prevent anger or anxiety escalating to unmanageable level when stressor recurs

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9
Q

Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Giving reassurance, Rejecting, Approving or Disapporving

A

Giving reassurance: May discourage client from further expression of feelings if client believes the feelings will only be downplayed or ridiculed

Rejecting: Refusing to consider client’s ideas or behavior

Approving or disapproving: Implies that the nurse has the right to pass judgement on the “goodness” or “badness” of a client’s behavior

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10
Q

Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Agreeing or disagreeing, Giving advice, and Probing

A

Agreeing or disagreeing: Implies that the nurse has the right to pass judgement on whether the client’s ideas or opinion are “right” or “wrong”

Giving advice: Implies that the nurse knows what is best for client and that client is incapable of any self-direction

Probing: Pushing for answers to issues that the client does not wish to discuss causes the client to feel used and valued only for what is shared with the nurse

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11
Q

Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Defending, Requesting an explanation, and Indicating the existence of an external source of power

A

Defending: To defend what client has criticized implies that the client has no right to express ideas, opinions, or feelings

Requesting an explanation: Asking “why” implies that the client must defend his or her behavior or feelings

Indicating the existence of an external source of power: Encourages client to project blame for his or her thoughts or behaviors on others

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12
Q

Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Belittling feelings expressed, Making stereotyped comments, cliches, and trite expressions, and Using denial

A

Belittling feelings expressed: Causes client to feel insignificant or unimportant.

Making stereotyped comments, cliches, and trite expressions: These are meaningless in a nurse-client relationship.

Using denial: Blocks discussion with client and avoids helping client identify and explore areas of difficulty.

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13
Q

Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Interpreting and Introducing an unrelated topic

A

Interpreting: Results in the therapist telling the client the meaning of his or her experience.

Introducing an unrelated topic: Causes the nurse to take over the direction of the discussion

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