THERAPEUTIC RELATIONSHIP + PROCESS RECORDING

THERAPEUTIC RELATIONSHIP

• The ability to establish ? with clients is one of the most important skills a psychiatric nurse can develop.

• Components include:

  • Trust

  • Genuine Interest

  • Empathy

  • Acceptance

  • Positive Regard

• Trust

• Genuine Interest

• Empathy

• Acceptance

• Positive Regard

Components of therapeutic relationship include?

TRUST

• Component of therapeutic relationship

• The nurse is friendly, caring, understanding, consistent; keeps promises; listens; is honest

• Congruence occurs when words and actions match.

GENUINE INTEREST

• Component of therapeutic relationship

• The nurse displays keen interest to learn or hear more about his/her client

EMPATHY

• Component of therapeutic relationship

• The ability to sense other people's emotions, coupled with the ability to imagine what someone else might be thinking or feeling.

ACCEPTANCE

• Component of therapeutic relationship

• ? of person, not necessarily his or her behavior

POSITIVE REGARD

• Component of therapeutic relationship

• Is unconditional and non-judgmental attitude. It is a technique that involves showing complete support and acceptance

Sympathy

• To acknowledge that someone is distressed

• Less therapeutic

• Boundaries are lost

• Encourages dependency

Empathy

• To actually understand how someone else is feeling

• You know their feelings but still set boundaries

Self-awareness

• is a process of understanding one’s own values, beliefs, thoughts, feelings, attitudes, motivations, strengths, and limitations and how one’s thoughts and behaviors affect others.

Johari Window Model

Self-awareness activity that involves writing open area, blind spot, hidden area, and unknown

Therapeutic use of self

• This is when the nurse uses aspects of his or her personality, experience, values, feelings, intelligence, needs, coping skills, and perceptions to establish relationships with clients that are beneficial to clients

pre-orientation phase

• Phase of therapeutic relationship

• chart reading

• self-awareness activity

• plan

orientation phase

• Phase of therapeutic relationship

• the nurse and client meet, roles are established, the purposes and parameters of future meetings are discussed, expectations are clarified, and the client’s problems are identified.

working phase

• Phase of therapeutic relationship

• involves problem identification, where the client identifies issues or concerns causing problems, and exploitation, when the nurse guides the client to examine his or her feelings and responses, develop better coping skills and a more positive self-image, change behavior, and develop independence.

Transference

• Common element that can arise during working phase

• This is when clients unconsciously transfer feelings they have for significant persons in their life onto the nurse

Countertransference

• Common element that can arise during working phase

• This is when the nurse responds to the client based on his or her own unconscious needs and conflicts

termination or resolution phase

• Phase of therapeutic relationship

• begins when the client’s problems are resolved and ends when the relationship is ended

• it is important to deal with feelings of anger or abandonment that may occur.

• Inappropriate boundaries

• sympathy, dependency

• Non-acceptance, avoidance

Behaviors That Diminish Therapeutic Relationships:

• ? (relationship becomes social or intimate)

• Feelings of ? and encouraging client ? rather than promoting independence

• ? of client as a person because of his or her behaviors, leading to ? of the client

PROCESS RECORDING

• Tool used for interaction with the clients with psychiatric illness.

• Technique by which we record the verbal interaction between the nurse and the client or it is the written record of the entire communication pattern between nurse and the client

• conscious

• interpreting, synthesizing

• awareness

• observational

Purpose of Process Recording:

• Assists the nurse to plan, structure, and evaluate the interaction on a ? rather than intuitive level

• Assists to gain competency in ? and ? raw data helps to consciously apply theory to practice

• Helps to increase ? of the nurse’s habitual, verbal and nonverbal communication pattern and the effect of those patterns on others

• Helps to increase ? skills as there is a conscious process involved in thinking, sorting and classifying the interaction under the various headings helps to increase the ability to identify the problems and gain skills in solving them

ADVISING, DISAPPROVING

Teaching must NOT be imposing by avoiding ? and ? (and other non thera-comms)