Therapeutic Communication

·       Communication, what is it?

o   We use communication to Identify and explore problems in relating to others.

o   Discover healthy ways of meeting emotional needs.

o   Experience a satisfying interpersonal relationship.

·       Preexisting conditions that influence communication

  • Values, attitudes, and beliefs

  • Culture or religion

  • Social status

  • Gender

  • Age or developmental level

  • Environment in which the transaction takes place

·       Territoriality

·       Density

·       Distance

·       These are all aspects of the environment that communicates messages.

·       Nonverbal Communication

o   Physical appearance and dress

o   Body movement and posture

o   Touch

o   Facial expressions

o   Eye behavior

o   Vocal cues or paralanguage

·       Therapeutic Communication Techniques

o   Therapeutic communication includes caregiver verbal and nonverbal techniques that focus on the care receiver’s needs and advance the promotion of healing and change.

o   Therapeutic communication encourages exploration of feelings and fosters understanding of behavioral motivation.

o   It is nonjudgmental, discourages defensiveness, and promotes trust.

o   Be familiar with Table 7-2 in your textbook

·       Therapeutic Communication

·       Attempting to translate words into feelings

·       Putting into words the feelings the client has expressed only indirectly

·       Using silence

·       Allows patient to take control of the discussion, if he or she so desires

·       Accepting

·       Conveys positive regard

·       Giving recognition

·       Acknowledging, indicating awareness

·       Offering self

·       Making oneself available

·       Giving broad openings

·       Allows client to select the topic

·       Offering general leads

·       Encourages client to continue

·       Placing the event in time or sequence

·       Clarifies relationship of events in time

·       Making observations

·       Verbalizing what is observed or perceived

·       Encouraging description of perceptions

·       Asking client to verbalize what is being perceived

·       Nontherapeutic Communication

·       Formulating a plan of action

·       Striving to prevent anger or anxiety from escalating to unmanageable level when stressor recurs

·       Encouraging comparison

·       Asking client to compare similarities and differences in ideas, experiences, or interpersonal relationships

·       Restating

·       Lets the client know whether an expressed statement has been understood

·       Reflecting

·       Directs questions or feelings back to client so that they may be recognized and accepted

·       Focusing

·       Taking notice of a single idea or even a single word

·       Exploring

·        Delving further into a subject, idea, experience, or relationship

·       Seeking clarification and validation

·       Striving to explain what is vague and searching for mutual understanding

·       Presenting reality

·       Clarifying misconceptions that the client may be expressing

·       Voicing doubt

·       Expressing uncertainty as to the reality of patient’s perception

·       Verbalizing the implied

·       Putting into words what patient has only implied

·       Active Listening

o   To listen actively is to be attentive to what patient is saying, both verbally and nonverbally.

o   Several nonverbal behaviors have been designed to facilitate attentive listening.

o   Acronym SOLER:

  • S: Sit squarely facing the patient

  • O: Observe an open posture

  • L: Lean forward toward the patient

  • E: Establish eye contact

  • R: Relax

·       Motivation Interviewing

o   Motivational interviewing is an evidence-based, patient-centered style of communicating that promotes behavior change by guiding the patient to explore their own motivation for change and the advantages and disadvantages of their decisions.

·       Process Recording

o   Process recordings are written reports of verbal interactions with clients.

o   They are written by the nurse or student as a tool for improving communication techniques.

·       Feedback

o   Feedback is a method of communication that helps the patient consider a modification of behavior.

o   It should be presented in a manner that discourages defensiveness on the part of the patient.