Mental Health Lecture 2

Therapeutic Communication Overview

• Definition: Therapeutic communication is the giving and receiving of information that promotes growth, development, maturity, and improved coping for clients with mental health disorders.
• Objective: To describe and differentiate therapeutic from non-therapeutic language, and apply therapeutic techniques with clients.

Communication Dynamics

• Human interaction is complex, involving significant sharing of feelings.

• Effective communication is essential in establishing therapeutic relationships between psychiatric nurses and clients.

• Types of Communication

• Intrapersonal: Self-talk (conversations with oneself).

• Interpersonal: Occurs between individuals.

• Therapeutic: Involves empathy and effective responses to clients’ needs, fostering trust.

Non-Therapeutic Communication

• Leads to feelings of defensiveness, misunderstanding, and isolation in clients.
• Common examples include minimizing feelings, giving advice, and lack of engagement.

Influencing Factors

• Cultural/Social Background: Different cultures have varying norms for expressing feelings.
• Attitudes: Caring versus judgmental attitudes impact client interactions.
• Past Experiences: Previous communication encounters shape perceptions and interactions.
• Knowledge and Relatability: Education level and personal disposition affect communication efficiency.

Verbal vs. Non-Verbal Communication

• Verbal: Includes spoken language, writing, and symbols. Importance of understanding client language.
• Non-Verbal: Involves tone, body language, and gestures. Reflects true feelings and attitudes.
• Example: Tone of voice, pausing, and gestures can convey emotion and intent.
• Contextual cues related to appearance can indicate emotional state (e.g., clothing, grooming).

Personal Space and Proxemics

• Ideal distance for therapeutic communication is 1.5 to 4 feet.
• Body language and posture convey emotional states (e.g., crossed arms for defensiveness).

Touch and Facial Expressions

• Touch should be approached with caution; permission should be sought.
• Facial expressions and eye contact are vital for effective communication, influencing how messages are interpreted.

Principles of Therapeutic Communication

• Acceptance: Clients feel respected and accepted.
• Interest and Respect: Demonstrating a desire to understand the client.
• Honesty and Concreteness: Being clear and specific in communication.
• Assistance and Permission: Showing availability to help and encouraging new behavior.
• Protection: Ensuring clients' safety during interactions.

Effective Communication Techniques

• Clarification: Ensures understanding of messages.
• Example: "Did I understand you correctly…?"
• Reflection and Restatement: Paraphrasing client's feelings.
• Example: "You're feeling hopeless about your daughter's marriage."
• Focusing: Directing attention to specific concerns.
• Silence: Allowing space for thought processing.
• Exploring and Sharing Perceptions: Encouraging deeper conversation.
• Example: "Tell me about what's been troubling you at home."
• Offering General Leads: Encouraging discussion.
• Assertiveness: Communicating respectfully without aggression.

Non-Therapeutic Techniques to Avoid

• Failure to Listen: Engaging in paperwork while a client is talking.
• False Reassurance: Minimizing clients' feelings.
• Close-Ended Questions: Limiting discussions and client participation.
• Avoid using too many yes/no questions.
• Changing the Subject: Avoiding sensitive topics.
• Challenging or Denial of Perception: Forcing clients to defend their feelings.
• Stereotyped Responses: Using clichés that do not foster real conversation.
• Superficial Comments: Offering empty responses instead of engaging meaningfully.
• Self-Focus: Neglecting client’s needs to share personal experiences.

Final Notes

• Practice and Preparation: Importance of practicing therapeutic communication skills in class activities.
• Social vs. Therapeutic Communication: Understanding the differences between general conversation and supportive, therapeutic interactions.