THERAPEUTIC COMMUNICATION Flashcards
is a two-way process between two or more individuals. It is an interaction between two or more people that involves the exchange of information between a sender and a receiver.
COMMUNICATION
The product of communication is the __________, which is interpreted by the receiver.
MESSAGE
In psychiatric nursing, ________ is one of the most important tools that nurses can use for building trust, developing therapeutic relationship, providing support and comfort, encouraging growth and change, and implementing patient education.
therapeutic communication
_________– in psychiatric nursing, the nurse, using verbal and nonverbal communication, is the primary therapeutic agent with psychiatric patients.
Therapeutic use of self
COMMUNICATION ARE INFLUENCED BY THE FOLLOWING FACTORS:
- Environmental Considerations
- Physical Considerations
- Kinesics Considerations
___________ – is a process in which the nurse consciously influences a CLIENT or helps the client to a better understanding through a verbal or non -verbal communication. It involves the use of specific strategies that encourage the patient to express feelings and ideas and that they convey acceptance and respect.
THERAPEUTIC COMMUNICATION
__________ – the GOAL is to increase self-worth or decrease psychological distress by collecting information to determine the illness, assessing and modifying the behavior, and providing health education.
SIGNIFICANCE
PRINCIPLES OF THERAPEUTIC COMMUNICATION:
● Concreteness
● Honesty
● Assistance
● Acceptance
● Interest
● Respect
● Empathy
● Protection
_______-caregivers are specific and clear when they communicate.
Concreteness
_________- consistent and open. They communicate with the client as authentic person.
Honesty
– commit time and energy to therapeutic relationships. Convey their presence.
Assistance
– it is only when people feel accepted for what they are that they will consider change.
Acceptance
– show or express the desire to know the other person.
Interest
– communicate willingness to work with client and accept their ideas, feelings and rights.
Respect
– understand feelings of patients.
Empathy
– always ensure client’s safety.
Protection
THERAPEUTIC TECHNIQUES:
- Offering self
- Active listening
- Exploring
- Giving broad openings
- Silence
- Stating and observing
- Encouraging comparisons
- Identifying themes
- Summarizing
- Placing the event in time and sequence
- Voicing doubt
- Encouraging descriptions of perceptions
- Presenting reality or confronting
- Seeking clarification
- Verbalizing the implied
- Reflecting
- Restating
- General leads
- Asking question
- Empathy
- Focusing
- Interpreting
- Encouraging Evaluation
- Suggesting Collaboration
- Encouraging goal setting
- Encouraging formulation of a plan of action
- Encouraging decisions
- Encouraging consideration of options
- Giving Information
- Limit Setting
- Supportive confrontation
- Role Playing
- Rehearsing
- Feedback
- Encouraging evaluation
- Reinforcement
● Making self-available and showing interest and concern
● “I will walk with you.”
Offering Self
● Paying close attention to what the patient is saying by observing both verbal and non-verbal cues.
● Maintaining eye contact and making verbal remarks to clarify and encourage further communication.
Active Listening
● “Tell me more about your son.”
Exploring
● What do you want to talk today?
Giving Broad Openings
● Planned absence or verbal remarks to allow patient and nurse to think over what is being discussed and say more.
Silence
● Verbalizing what is observed in the patient for validation and to encourage discussion.
● “You sound angry.
Stating and Observing
● Asking to describe similarities and differences among feelings, behaviors and events.
● “Can you tell me what makes you more comfortable, working by yourself or working as a member of a team?”
Encouraging Comparison
● Asking to identify recurring thoughts, feelings and behaviors.
● “When do you always feel the need to check the locks and doors?”.
Identifying themes
● Reviewing the main points of discussion and making appropriate conclusions.
● “During this meeting, we discussed about what you will do when you feel the urge to hurt yourself again and this include…”
Summarizing
● Asking for relationships among events.
● “When do you begin to experience this tick? Before or after you entered grade school?”.
Placing the event in time and sequence
● Voicing uncertainty about the reality of patient’s statements, perceptions and
conclusions.
● “I find it hard to believe…”
Voicing doubt
● Asking the patients to describe feelings, perceptions and views of their situations.
● “What are these voices telling you to do.”
Encouraging descriptions of perceptions
● Stating what is real and what is not without arguing with the patient.
● “I know you hear these voices, but I do not hear them”.
● “I am Deborah, your nurse, and this is a hospital and not a beach resort”.
Presenting reality or confronting
● Asking the patients to restate, elaborate, or give examples of ideas or feelings to seek clarification of what is unclear.
● “I am not familiar with your work; can you describe it further for me”.
● “I don’t think, I understand what you are saying”.
Seeking clarification
● Rephrasing patient’s words to highlight an underlying message to clarify
statements.
● Patient: I will not be bothering you anymore soon.
● Nurse: Do you think you should leave now?
Verbalizing the implied
● Throwing back the patient’s statements in a form of questions helps the patient
identify feelings.
● Patient: I think I should leave you now
● Nurse: Do you think you should leave now?
Reflecting
● Repeating the exact words of patients to remind them of what they said and to let them know they are heard.
● Patient: I cannot sleep. I stay awake all night.
● Nurse: You cannot sleep at night?
Restating
● Using neutral expressions to encourage patients to continue talking.
● “Go on…”
● “You were saying…”
General leads
● using open-ended questions to achieve relevance and depth in discussion.
● “How did you feel when the doctor told you that you are ready for discharge soon?”
Asking question
● Recognizing and acknowledging patient’s feelings
● “It’s hard to begin to live alone when you have been married for more than thirty years”.
Empathy
● Pursuing a topic until its meaning or importance is clear.
● “Let us talk more about your best friend in college.”
● “You were saying…”
Focusing
● Providing a view of the meaning or importance of something.
● Patient: I always take this towel wherever I go.
● Nurse: That towel must always be with you.
Interpreting
● Asking for patients views of the meaning or importance of something.
● “What do you think led to court to commit you here?”.
● “Can you tell me the reasons you don’t want to be discharged?”.
Encouraging Evaluation
● Offering to help patient solve problems.
● “Perhaps you can discuss this with your children so they will know how you feel and what you want”.
Suggesting Collaboration
● Asking patient to decide on the type of change needed.
● “What do you think about the things you have to change in yourself?”.
Encouraging goal setting
● Probing for step-by-step actions that will be needed.
● “If you decide to leave home when your husband beat you again and what will you do
next?”.
Encouraging formulation of a plan of action
● Asking patients to make a choice among options.
● “Given all these choices, what would you prefer to do?”.
Encouraging decisions
