Table 9.2 Therapeutic Communication Techniques Flashcards
silence
gives the patient time to collect thoughts or think through a point
enouraging a person to talk by waiting for the answers
silence
accepting
indicates that the person has been understood. An accepting statement does not necessarily indicate agreement but its nonjudgemental
“yes”
“uh-huh”
“I follow what you say”
accepting
giving recognition
indicates awareness of change and personal efforts. Does not imply good or bad, right or wrong
“good morning mr jones, I see you combed your hair”
“I see you ate your whole meal”
giving recognition
offering self
offers presence, interest, and desire to understand. Is not offering to get the person too talk or behave in a specific way
“I would like to spend time with you”
“Ill stay here and sit with you for awhile”
offering self
offering general leads
allows the other person to take direction in the discussion. indicates that the nurse is interested in what comes next
“go on”
“and then?”
“Tell me about it”
offering general leads
giving broad openings
clarifies that the lead is to be taken by the patient, however the nurse discourages pleseantireis and small talk
placing the events in time or sequence
puts events and actions in better perspective
notes cause and effect relationships and identifies patterns of interpersonal duties
“what happened before”
“When did this happen”
placing events in time or sequence
making observation
calls attention to the persons behavior. encourages patient to notice the behavior and describe thoughts and feelings for mutual understanding. helpful with mute and withdrawn people
“you appear tense”
“I notice you are biting your lip”
“you seem nervous whenever John enters the room”
making observation
encouraging description of perception
increases the nurses understanding of the patients perceptions. talking about feelings and difficulties can lessen the need to act them out inappropriately
“what do these voices seem to be saying”
“what is happening now”
“tell me when you feel anxious”
encouraging description of perception
encouraging compassion
brings out recurring themes in experiences or interpersonal relationships. helps the person clarify similarities and differences
“has this happened before”
“is this how you felt”
“was it something like…”
encouraging compassion
restating
repeats the main idea expressed. gives the patient an idea of what has been communicated. if the message has been misunderstood, the patient can clarify
“I can’t sleep, I stay awake at night”
- “you are having difficulties sleeping”
restating
reflecting
directs questions, feelings, and ideas back to the patient. encourages the patient to accept personal ideas and feelings. acknowledges the patients right to have opinions and make decisions and encourages the patient to thing of oneself as capable person
“what do you think I should do about my husbands affair”
- “what do you think you should do”
reflecting
focusing
concentrates attention on a single point. it is especially useful when the patient jumps from topic to topic. If a person is experiencing a severe or panic level of anxiety the nurse should not persist until anxiety lessens
“this point you are making about leaving school seems worth looking at more closely”
“you’ve mentioned many things, lets go back to your thinking of ending it all”
focusing
exploring
examines certain ideas, experiences or relationships more fully. if the patient chooses not to elaborate by answering no, the nurse does not probe or pry. In such case the nurse respects the patients wishes
“tell me more about that”
“would you describe it more fully”
“could you talk about how it was that you learned your mom was dying of cancer”
exploring
giving information
makes facts the person needs available. supplies knowledge from which decisions can be made or conclusions drawn.
EX: the patient needs to know the role of the nurse, the purpose of the nurse patient relationship
“this medication is for…”
“the test will determine…”
giving information
seeking clarification
helps patients clarify their own thoughts and maximize mutual understanding between nurse patient
“I am not sure I follow you”
“what would you say the main point of what you just said is”
“give an example of a time you thought everyone hated you”
seeking clarification
presenting reality
indicates what is real. the nurse does not argue or try to convince the patient, just describes personal perceptions of facts in the situation
“that was dr.todd not a man from the mafia”
“that was the sound of a car backfiring”
“your mother is not here, I’m the nurse”
presenting reality
voicing doubt
expressing uncertainty regarding the reality of the patients perceptions or conclusions, especially in hallucinations and delusions
“isnt thay unsual”
“I find that hard to believe’
voicing doubt
seeking consensual validation
clarifies that both the nurse and patient share mutual understanding of communications. helps the patient to clarify thoughts
“tell me whether my understanding agrees with yours”
seeking consensual validation
verbalizing the implied
puts into concrete terms what the patient implies, making the patients communication more explicit
“I can’t talk to you or anyone, its a waste of time”
- “do you feel like no one understands”
verbalizing the implied
encouraging evaluation
aids the patient in considering other persons and events from the perspective of the patients own set of values
“how do you feel about….”
“what did it mean to you when he said he couldn’t stay…”
encouraging evaluation
attempting to translate into feelings
responds to the feelings expressed, not just the content. often termed decoding
“I am dead inside”
- “are you saying you feel lifeless? does life seem meaningless to you?”
attempting to translate into feelings
suggesting collaboration
emphasizes working with the patient, not doing things for the patient. encourages the view that change is possible through collaboration
“perhaps you and I could discover what produces anxiety.”
“by working together we can come up with some ideas that might improve your communication with your spouse”
suggesting collaboration
summarizing
brings together important points of discussion to enhance understanding. Aldo allows the opportunity to clarify communications to that both nurse and patient leave the interview with the same idea in mind
“have I got this straight”
“you said that…”
“during the past hour you and I have discussed”
summarization
encouraging formulation of a plan of action
allows the patient to identify alternative actions for interpersonal situations the patient finds disturbing
“what could you do to let the anger out harmlessly?”
“the next time it comes up, what might you do to handle it”
“what are some other ways you can approach your boss”
encouraging formulation of a plan of action
