Therapeutic Communication Flashcards
What is a social relationship?
** Dont want with the patient**
- used for friendships, socializations, enjoyment, or accomplishment
- give advice and ask for help
- content of communication: superficial
Therapeutic communication
** FOUCUS ON THE PT NEEDS**
-clear boundaries established ( no phone #, social media shared )
- problem solving approaches taken
- new coping skills developed
- behavioral change encouraged
Conditions Essential to Development of a Therapeutic Relationship
- Rapport= talk about whats going on, play games, ice breaker
- Trust- that you are not going to judge them
- Respect- display kindness to them
- Genuine- be yourself
- Empathy- understand from clients point of view
4 Phases of a Therapeutic nurse Client Relationship
- Pre-interaction phase( gather info, self reflection, may this client trigger me )
- Orientation/ Introductory Phase ( build rapport, maintain confidentiality )
- Working phase ( identify the problem, help with coping mechanism etc. )
- Termination Phase ( saying goodbye )
What is the phase when most resistance occurs?
The working phase
Working Phase: Therapeutic Impasses
- RESISTENCE= attempt by client to remain unware of anxiety producing aspects within oneself
1a. Intensification of sx (“fight into health”) = head/ stomach starts to hurt
1b. Shrug shoulders “ I dont know” = social cue to back off, its causing anxiety - TRANSFERENCE= the unconscious response in which client experiences feelings/ attitudes toward the nurse that were originally associated with significant figures in their early life
EX: Pt had a bad experience w/ their mom, you resemble her so they treat you bad
EX: Pt had a good experience with their mom and you resemble her , so they cling to you - COUNTERTRANSFERENCE= when the nurse projects their feelings onto the patient
3 types
a. intense love/caring
b. intense distrust or hostility
c. intense anxiety/ discomfort
How to overcome resistance and transference?
Slow down and recognize that the pt may not be ready to deal w/ some issues now– cant face
How to overcome Countertransference?
Identify the problem and talk about it
Boundaries
- when people get in your face
- never probe when getting information
- dont disclose too much information about yourself
- cant take expensive gifts
- NO TOUCHING
- NO FRIENDSHIP/ ROMANTIC ASSOCIATION
General Rules for Communication: DO’s
- Acknowledge what the person is feeling + the right to feel that way
- Use open-ended questions
- Acknowledge whatever their seeing/hearing/ believing is real to them, but voice that you dont hear/see it
- Acknowledge their belief w/o stating your own
- Ask them to clarify if you dont understand
- Ask them about problems/issues tehy have
- Restate what they say to let them know you heard them right
General Rules for Communication: DONT’s
- Ask ‘Why?” questions
- Ask for all details of traumas
3, Argue with patient about beliefs - False hope
- Give advice, approval, disapproval, false encouragement
- NO SECRETS
Active Listening
To be attentive to what client is saying bot verbally and nonverbally
S= sit facing client
O= observe open posture
L= lean forward toward client
E= Establish eye contact
R = relax
