Therapeutic Communication

Question 1

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/

Answer 1

Therapeutic Communication

Question 2

Goal of “Therapeutic Communication”

Answer 2

Establish a therapeutic nurse - client relationship

Question 3

Therapeutic Communication:

This indicates reception

Example: “Yes” ; “I follow what you said” ; Nodding

Answer 3

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.

Question 4

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?”

Answer 4

Broad Openings

Rationale: Broad openings makes explicit that the client is leading the interaction ; may stimulate him or her to take the initiative.

Question 5

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?’

Answer 5

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.

Question 6

Therapeutic Communication:

Helping the client to understand by looking at similarities and differences.

Example: “Was it something like?” ; “Have you had similar experiences?”

Answer 6

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.

Question 7

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?”

Answer 7

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.

Question 8

Therapeutic Communication:

Asking client to appraise the quality of this her experience.

Example: “What are your feelings in regard to?”

Answer 8

Encouraging Expression

Rationale: Encourages the client to make his or her own appraisal rather than accepting the opinion of others.

Question 9

Therapeutic Communication:

Delving further into a subject or idea.

Example: “Tell me more that about that” ; “Would you describe it more fully?”

Answer 9

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.

Question 10

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?”

Answer 10

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.

Question 11

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?”

Answer 11

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.

Question 12

Therapeutic Communication:

Giving encouragement to continue.

Example: “Go on.” ; “And then?” ; “Tell me about it.”

Answer 12

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.

Question 13

Therapeutic Communication:

Making available the facts that the client needs.

Example: “My name is…” ; “Visiting hours are…” ; “My purpose in being here is…”

Answer 13

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.

Question 14

**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.”

Answer 14

**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

Question 15

Therapeutic Communication:

Verbalizing what the nurse perceives.

Examples: “You appear tense.”; “Are you uncomfortable when . . ?”; “I notice that you are biting your

Answer 15

Making Observation

Rationale: Sometime clients cannot verbalize or make themselves understood.

Question 16

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.”

Answer 16

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.

Question 17

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?”

Answer 17

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.

Question 18

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.”

Answer 18

Presenting Reality

Rationale: When it is obvious that a client is misinterpreting reality, the nurse can indicate what is real.

Question 19

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’?”

Answer 19

Reflecting

Rationale: This encourages the client to recognize and accept his or her own feelings.

Question 20

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.”

Answer 20

Restating

Rationale: Restatement lets the client know that he or she communicated the idea effectively; encourages the client to continue.

Question 21

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?”

Answer 21

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.

Question 22

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.

Answer 22

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.

Question 23

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.

Answer 23

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

Question 24

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..”

Answer 24

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

Question 25

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.”

Answer 25

Translation Into Feelings

Rationale: The nurse must concentrate on what the client might be feeling to express himself or herself this way.

Question 26

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?

Answer 26

Verbalizing the Implied

Rationale: This tends to make the discussion less obscure.

Question 27

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.”

Answer 27

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.