Communication Skills (Psych)

Acceptance

Definition

Encouraging and receiving information in a nonjudgmental and interested manner

Example

Patient: “I have done something terrible.” Nurse: “I would like to hear about it. It’s OK to discuss it with me.”

Use

Used in establishing trust and developing empathy.

Confrontation

Definition

Presenting the patient with a different reality of the situation.

Example

Patient: “My doctor won’t talk to me.” Nurse: “I was in the room yesterday when you refused to speak with him.”

Use

Used cautiously to immediately redefine the patient’s reality. However, it can alienate the patient if used inappropriately. A nonjudgmental attitude is critical for confrontation to be effective.

Doubt

Definition

Expressing or voicing doubt when a patient relates a situation.

Example

Patient: “My best friend hates me. She never calls me.” Nurse: “From what you have told me, that does not sound like her. When did she call you last?”

Use

Used carefully and only when the nurse feels confident about the details. It is used when the nurse wants to guide the patient toward other explanations.

Interpretation

Definition

Putting into words what the patient is implying or feeling.

Example

Patient: “I could not sleep because someone would come into my room and rape me.” Nurse: “It sounds like you were scared last night.”

Use

Used in helping the patient identify underlying thoughts or feelings.

Observation

Definition

Stating to the patient what the nurse is observing.

Example

Nurse: “You are trembling and perspiring. When did this start?”

Use

Used when a patient’s behaviors (verbal or nonverbal) are obvious and unusual for that patient.

Open-ended statements

Definition

Introducing an idea and letting the patient respond.

Example

Nurse: “Trust means…” Patient: “That someone will keep you safe.”

Use

Used when helping the patient explore feelings or gain insight.

Reflection

Definition

Redirecting the idea back to the patient for classification of important emotional overtones, feelings, and experiences; it gives patients permission to have feelings they may not realize they have.

Example

Patient: “Should I go home for the weekend?” Nurse: “Should you go home for the weekend?”

Use

Used when the patient is asking for the nurse's approval or judgment; use of reflection helps the nurse maintain a nonjudgmental approach.

Restatement

Definition

Repeating the main idea expressed lets the patient know what was heard.

Example

Patient: “I hate this place. I don’t belong here.” Nurse: “You don’t want to be here.”

Use

Used when trying to clarify what the patient has said.

Silence

Definition

Remaining quiet but non verbally expressing interest during an interaction.

Example

Patient: “I am angry!” Nurse: (silence) Patient: “My wife had an affair.”

Use

Used when the patient needs to express ideas but may not know quite how to do it; with silence, the patient can focus on putting thoughts together.

Validation

Definition

Clarifying the nurse’s understanding of the situation.

Example

Nurse: “Let me see if I understand.”

Use

Used when the nurse is trying to understand a situation the patient is trying to describe.