Transcript Therapeutic Communication Techniques 1-22

Therapeutic Communication
NUR 3051
Rochelle Roberts MS RN
 Therapeutic Communication –
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Undertaken to carry out the nursing care plan
Purposeful
Has one or more goals
Aimed at meeting the needs of one of the
participants
– Self-disclosure by the interviewer is limited
Social Communication
– May not have any specific goal
– May not be purposeful
– Meets the needs of all the participants
– May be significant self-disclosure of all
participants
Aids to Communication
 Active listening
– Expression of interest
– Leaning forward
– Nodding head
– Verbalizations such as “Uh-huh” and “Go on…”
– Frequent validation
– Attempt to fully understand
 Silence
– If you don’t know what to say, say nothing
– Gives patient time to think
– Gives nurse time to think
– May allow patient to expand upon what he was
saying or think of a new topic to discuss
– As anxiety grows, patient is more likely to say
something
 Exploring
– Trying to get the patient to expand upon a topic
or bring up another topic
– “Would you tell me more about that?”
– “What else makes you feel that way?”
 Restating
– Pt.: “I couldn’t sleep all night.”
– Nurse:”You couldn’t sleep all night.” or
“You couldn’t sleep all night?”
– Pt.: “My husband is very worried about me.”
– Nurse:”Your husband is very worried about
you.”
“Your husband is very worried about you?”
 Theme Identification
 “I’ve noticed that in all of the relationships
that you have described, you’ve been hurt or
rejected by the man. Do you think this is an
underlying issue?”
 Paraphrasing
– Repeating what the patient says in different
words
– Pt.: “I’m worried about my operation tomorrow.”
– Nurse: “You’re concerned about tomorrow’s
surgery.” (or ?)
 Suggesting
 “Have you thought about responding to your
boss in a different way when he raises that
issue with you?”
 Reflecting or validating
- signifies understanding, empathy, interest,
and respect for the patient. It consists of
repeating in fewer and different words the
essential ideas of the patient. (similar to
paraphrasing) Reflection can refer to
content or feelings.
 Open-ended questions
 “Tell me what happened?”
 “How are you today?”
 Focusing –
 “Can we continue talking about your mother
right now?”
 Clarifying, validating
 “I’m having some difficulty. Could you help
me understand?”
 Humor
 “That gives whole new meaning to the word
nervous,” (said with shared kidding between
the nurse and the patient).
 Summarizing
-”So far we have talked about..”
 Informing
 “I think you need to know more about how
your medication works.”
Non-therapeutic Communication
 False Reassurance
– “Everything’s going to be all right.”
– “You’re doing just fine.”
– Pt.: “I’m afraid I won’t wake up from the
surgery.”
– Nurse:”Sure you will.”
Barriers cont.
 Giving approval or disapproval; being
judgmental; agreeing or disagreeing
– “I wouldn’t say that.”
– “Of course; I agree.”
Barriers cont.
 Giving advice
– “If I were you…”
– “I think you should…”
– “It seems to me the best course of action is…”
Barriers cont.
 Defending
– Pt.: “The nurses were very slow
answering my light last night.”
– Nurse:”I don’t know how you can say that. This
floor has the best nurses in the hospital.”
Barriers cont.
 Minimizing feelings
– Pt.: “I’m quite scared about this surgery.”
– Nurse:”Oh, everyone feels that way before an
operation.”
– Pt.: ”I really hate shots.”
– Nurse.”Don’t be silly. It’s just a little stick.”
Barriers cont.
 Changing the subject
– Pt.: “I hope someone comes to visit me today.”
– Nurse:”It’s such a beautiful day today.”
 Social response
- nurse uses superficial social conversation
that is not client-centered.
- “How does the coffee taste today?”
Responsive dimensions
 Genuineness- the nurse is open, honest,
and sincere.
 Respect- unconditional positive regard. The
nurse’s attitude is nonjudgmental.
 Empathy- sensitivity to the pt’s current
feelings and the verbal ability to
communicate this understanding.