Table 9.2 Therapeutic Communication Techniques

Question 1

silence

Answer 1

gives the patient time to collect thoughts or think through a point

Question 2

enouraging a person to talk by waiting for the answers

Answer 2

silence

Question 3

accepting

Answer 3

indicates that the person has been understood. An accepting statement does not necessarily indicate agreement but its nonjudgemental

Question 4

“yes”
“uh-huh”
“I follow what you say”

Answer 4

accepting

Question 5

giving recognition

Answer 5

indicates awareness of change and personal efforts. Does not imply good or bad, right or wrong

Question 6

“good morning mr jones, I see you combed your hair”
“I see you ate your whole meal”

Answer 6

giving recognition

Question 7

offering self

Answer 7

offers presence, interest, and desire to understand. Is not offering to get the person too talk or behave in a specific way

Question 8

“I would like to spend time with you”
“Ill stay here and sit with you for awhile”

Answer 8

offering self

Question 9

offering general leads

Answer 9

allows the other person to take direction in the discussion. indicates that the nurse is interested in what comes next

Question 10

“go on”
“and then?”
“Tell me about it”

Answer 10

offering general leads

Question 11

giving broad openings

Answer 11

clarifies that the lead is to be taken by the patient, however the nurse discourages pleseantireis and small talk

Question 12

placing the events in time or sequence

Answer 12

puts events and actions in better perspective
notes cause and effect relationships and identifies patterns of interpersonal duties

Question 13

“what happened before”
“When did this happen”

Answer 13

placing events in time or sequence

Question 14

making observation

Answer 14

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 helpful with mute and withdrawn people

Question 15

“you appear tense”
“I notice you are biting your lip”
“you seem nervous whenever John enters the room”

Answer 15

making observation

Question 16

encouraging description of perception

Answer 16

increases the nurses understanding of the patients perceptions. talking about feelings and difficulties can lessen the need to act them out inappropriately

Question 17

“what do these voices seem to be saying”
“what is happening now”
“tell me when you feel anxious”

Answer 17

encouraging description of perception

Question 18

encouraging compassion

Answer 18

brings out recurring themes in experiences or interpersonal relationships. helps the person clarify similarities and differences

Question 19

“has this happened before”
“is this how you felt”
“was it something like…”

Answer 19

encouraging compassion

Question 20

restating

Answer 20

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

Question 21

“I can’t sleep, I stay awake at night”
- “you are having difficulties sleeping”

Answer 21

restating

Question 22

reflecting

Answer 22

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

Question 23

“what do you think I should do about my husbands affair”
- “what do you think you should do”

Answer 23

reflecting

Question 24

focusing

Answer 24

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

Question 25

“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”

Answer 25

focusing

Question 26

exploring

Answer 26

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

Question 27

“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”

Answer 27

exploring

Question 28

giving information

Answer 28

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

Question 29

“this medication is for…”
“the test will determine…”

Answer 29

giving information

Question 30

seeking clarification

Answer 30

helps patients clarify their own thoughts and maximize mutual understanding between nurse patient

Question 31

“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”

Answer 31

seeking clarification

Question 32

presenting reality

Answer 32

indicates what is real. the nurse does not argue or try to convince the patient, just describes personal perceptions of facts in the situation

Question 33

“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”

Answer 33

presenting reality

Question 34

voicing doubt

Answer 34

expressing uncertainty regarding the reality of the patients perceptions or conclusions, especially in hallucinations and delusions

Question 35

“isnt thay unsual”
“I find that hard to believe’

Answer 35

voicing doubt

Question 36

seeking consensual validation

Answer 36

clarifies that both the nurse and patient share mutual understanding of communications. helps the patient to clarify thoughts

Question 37

“tell me whether my understanding agrees with yours”

Answer 37

seeking consensual validation

Question 38

verbalizing the implied

Answer 38

puts into concrete terms what the patient implies, making the patients communication more explicit

Question 39

“I can’t talk to you or anyone, its a waste of time”
- “do you feel like no one understands”

Answer 39

verbalizing the implied

Question 40

encouraging evaluation

Answer 40

aids the patient in considering other persons and events from the perspective of the patients own set of values

Question 41

“how do you feel about….”
“what did it mean to you when he said he couldn’t stay…”

Answer 41

encouraging evaluation

Question 42

attempting to translate into feelings

Answer 42

responds to the feelings expressed, not just the content. often termed decoding

Question 43

“I am dead inside”
- “are you saying you feel lifeless? does life seem meaningless to you?”

Answer 43

attempting to translate into feelings

Question 44

suggesting collaboration

Answer 44

emphasizes working with the patient, not doing things for the patient. encourages the view that change is possible through collaboration

Question 45

“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”

Answer 45

suggesting collaboration

Question 46

summarizing

Answer 46

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

Question 47

“have I got this straight”
“you said that…”
“during the past hour you and I have discussed”

Answer 47

summarization

Question 48

encouraging formulation of a plan of action

Answer 48

allows the patient to identify alternative actions for interpersonal situations the patient finds disturbing

Question 49

“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”

Answer 49

encouraging formulation of a plan of action