Therapeutic Communication Flashcards
It is an interpersonal interaction between the nurse and client which the nurse focuses on the client’s specific needs to promote effective exchange of information/
Therapeutic Communication
Goal of “Therapeutic Communication”
Establish a therapeutic nurse - client relationship
Therapeutic Communication:
This indicates reception
Example: “Yes” ; “I follow what you said” ; Nodding
Accepting
Rationale: An accepting response indicates the nurse has heard and followed the train of thought. It does not indicated agreement but is non-judgmental.
Therapeutic Communication:
Allowing the client to take the initiative in introducing the topic.
Example: “Is there something you’d like to talk about?” ; “Where would you like me to begin?”
Broad Openings
Rationale: Broad openings makes explicit that the client is leading the interaction ; may stimulate him or her to take the initiative.
Therapeutic Communication:
Searching for mutual understanding, for accord in the meaning of the words.
Example: “Tell me whether my understanding of it agrees with you.” ; “Are you using this word to convey that?’
Consensual Validation
Rationale: For verbal communication to be meaningful, it is essential that the words being used should have the same meaning for all participants.
Therapeutic Communication:
Helping the client to understand by looking at similarities and differences.
Example: “Was it something like?” ; “Have you had similar experiences?”
Encouraging Comparison
Rationale: Comparing ideas, experiences, or relationships brings out many recurring themes ; he she might recall past coping strategies that were effective or remember that he or she has survived a similar situation.
Therapeutic Communication:
Asking client to verbalize what he or she perceives.
Examples: “Tell me when you feel anxious.” ; “What is happening?” ; “What does the voice seem to be saying?”
Encouraging Description of Perceptions
Rationale: To understand the client. The nurse must see things from his or her perspective ; may relieve the tension that the client is feeling and he or she might be less likely to take action on ideas that are harmful or frightening.
Therapeutic Communication:
Asking client to appraise the quality of this her experience.
Example: “What are your feelings in regard to?”
Encouraging Expression
Rationale: Encourages the client to make his or her own appraisal rather than accepting the opinion of others.
Therapeutic Communication:
Delving further into a subject or idea.
Example: “Tell me more that about that” ; “Would you describe it more fully?”
Exploring
Rationale: This can help them examine the issue more fully; If the client expresses an unwillingness to explore a subject, however, the nurse must respect his or her wishes.
Therapeutic Communication:
Concentrating on a single point.
Example: “This point seems looking at more closely.” ; “Of all concerns you have mentioned, which is most troublesome?”
Focusing
Rationale: This encourages the client to concentrate his or her energies on a single point, which may prevent a multitude of factors or problems form the client ; useful technique when a client jumps from one topic to another.
Therapeutic Communication:
Asking the client to consider kinds of behavior to be appropriate in future situations.
Example: “What could you do to let your anger out harmlessly?” ; Next time this comes up, what might you do to handle it?”
Formulating a Plan of Action
Rationale: It may be helpful for the client to plan in advance what he or she might do in future similar situations ; making definite plans increases the likelihood that the client will cope more affectively in a similar situation.
Therapeutic Communication:
Giving encouragement to continue.
Example: “Go on.” ; “And then?” ; “Tell me about it.”
General Leads
Rationale: This indicates that the nurse is listening and following what the client is saying without taking away the initiative for the interaction ; encourage the client to continue of he or she is hesitant or uncomfortable about the topic.
Therapeutic Communication:
Making available the facts that the client needs.
Example: “My name is…” ; “Visiting hours are…” ; “My purpose in being here is…”
Giving information
Rationale: Informing the client of facts increases his or her knowledge about a topic or lets the client know what to expect ; builds trust with the client.
**Therapeutic Communication: **
Acknowledging, indicating awareness.
*Example: *
“Good morning Mr./Ms…” ; “You’ve finished your list of things to do.”’ “I noticed that you’ve combed your hair.”
**Giving Recognition **
*Rationale: *
Greeting the client by name, indicating awareness of change, or noting efforts the client has made all show that the nurse recognizes the client as a person, as an individual
Therapeutic Communication:
Verbalizing what the nurse perceives.
Examples: “You appear tense.”; “Are you uncomfortable when . . ?”; “I notice that you are biting your
Making Observation
Rationale: Sometime clients cannot verbalize or make themselves understood.
Therapeutic Communication:
Making oneself available.
Example: “I will sit with you for a while.” ; “I will stay here with you.” ; “I am interested in what you think.”
Offering Self
Rationale: The nurse can offer his or her presence, interest, and desire to understand; It is important that this offer is unconditional, that is, the client does not have to respond verbally to get the nurse’s attention.
Therapeutic Communication:
Clarifying the relationship of events in time.
Example: What seemed to lead up to?”; Was this before or after?”; ‘When did this happen?”
Placing event in Time Sequence
Rationale: This helps both the nurse and client ‘to see them in perspective; The client may gain insight into cause-and-effect behavior and consequences, or perhaps some things are not related. The nurse may gain information about recurrent patterns or themes in the client behavior relationship.
Therapeutic Communication:
Offering for consideration that which is real.
Example: “I see no one else in the room.”; “That sound was a car back firing.”; “Your mother is not here and I am a your nurse.”
Presenting Reality
Rationale: When it is obvious that a client is misinterpreting reality, the nurse can indicate what is real.
Therapeutic Communication:
Directing client actions, thoughts, and feeling back to the client.
Example:
Client: “Do you think I should tell the doctor?”
Nurse: “Do you think you should?”
Client: “My brother spends all my money and then has the nerve to ask for more.”
Nurse: “This causes you to feel angry’?”
Reflecting
Rationale: This encourages the client to recognize and accept his or her own feelings.
Therapeutic Communication:
Repeating the main idea expressed.
Example:
Client: “I can’t sleep. I stay awake all night.” Nurse: “You have difficulty sleeping.”
Client: “I am really mad. I am really upset.”
Nurse: “You’re really mad and upset.”
Restating
Rationale: Restatement lets the client know that he or she communicated the idea effectively; encourages the client to continue.
Therapeutic Communication:
Seeking to make clear that which is not meaningful or that which is vague.
Example:
“I am not sure that I follow.” ; “Have I heard you correctly?”
Seeking Information
Rationale: This can help the nurse to avoid making assumptions that understanding has occurred when it has not; helps the client to articulate thoughts, feelings, and ideas more clearly.
Therapeutic Communication:
Absence of verbal communication, which provides time for the client to put thoughts or feelings in to words, regain
composure, or continue talking.
Example:
Nurse says nothing but continues to maintain eye contact and conveys interest.
Silence
Rationale: This often encourages the client to verbalize provided that it is interested and expectant; gives the client time
to organize thoughts, direct the topic of interaction, or focus on issues that are most important.
Therapeutic Communication:
Offering to share, to shrive, to work with the client for his or her benefit.
Example:
“Perhaps you and I can discuss and discover the triggers for your anxiety.” ; “Let’s go to your room and I will
help you find what you are looking for.
Suggestion Collaboration
Rationale: The nurse seeks to offer a relationship in which the client can identify problems in living with others, grow
emotionally, and improve the ability to form satisfactory relationships
Therapeutic Communication:
Organizing and summing up that which has gone before.
Example:
“Have I got this straight?” ; “You’ve said that. .” ; “During the past hour, you and I have discussed..”
Summarizing
Rationale: This brings out the important points of the discussion and to increase the awareness and understanding of
both participants ; omits the irrelevant and organizes the pertinent aspects of the interaction
Therapeutic Communication:
Seeking to verbalize client’s feelings that he or she expresses only indirectly.
Examples:
Client: “I am dead.”
Nurse: “Are you suggesting that you feel lifeless?”
Client: “I am way out in the ocean.”
Nurse: “You seem to feel lonely or deserted.”
Translation Into Feelings
Rationale: The nurse must concentrate on what the client might be feeling to express himself or herself this way.
Therapeutic Communication:
Voicing what the client has hinted or suggested.
Example:
Client: “I can’t talk to you or anyone. It is a waste of time.”
Nurse: “Do you feel that no one understands?
Verbalizing the Implied
Rationale: This tends to make the discussion less obscure.
Therapeutic Communication:
Expressing uncertainty about the reality about the reality of the client’s perceptions.
Example:
“Isn’t that unusual?” ; “Really?” ; “That is hard to believe.”
Voicing Doubt
Rationale: This permits the client to become aware that others do not necessarily perceive events in the same way or draw the same conclusions.
