THERAPEUTIC COMMUNICATION  Social (4-12 ft)

 Public (12-25 ft)

Therapeutic communication: most
Communication
comfortable when nurse and patient are 3-6
- Exchange of info
ft apart.
- Verbal
Context: literal words spoken
THERAPEUTIC COMMUNICATION #4
Context: environment, circumstances,
Touch
situation in which communication
 Five types: functional/professional;
occurs.
social-polite; friendship-warmth; love-
- Nonverbal
intimacy; sexual-arousal.
Process: all messages used to give
 Comforting and supportive when
meaning, context to message
welcome and permitted.
Congruent or incongruent messages
 Can be possible invasion of intimate and
personal space.
Therapeutic Communication #1  The nurse must evaluate use of touch
based on the client’s preferences,
 Interpersonal interactions; focus on
history, and needs.
client’s needs
 Nurse may find touch supportive, client
 Need for privacy
may not.
 Encompasses goals that facilitate the
nursing process
 Needed to effectively meet the
THERAPEUTIC COMMUNICATION #5
standards of client care.
 Active listening (concentrating
exclusively on what patient says)
 Active observation (watching nonverbal
THERAPEUTIC COMMUNICATION #2
actions as speaker communicates)
GOALS OF THERAPEUTIC COMMUNICATION
 These help the nurse:
 Establish therapeutic nurse-client
- Recognize the most important issue
relationship.
- Know what questions to ask
 Identify the most important client’s
- Use therapeutic communication
concerns; Assess client’s perceptions.
technique
 Facilitate client’s expression of
- Prevent jumping to conclusions
emotions.
- Objectively respond to message
 Teach client and family the necessary
self-care skills.
 Recognize client’s needs.
VERBAL COMMUNICATION SKILLS #1
 Implement interventions to address
 Need for concrete, not abstract,
client’s needs.
messages
 Guide client toward acceptable
 Techniques
solution.
- Exploring, focusing, restating, reflecting,
etc.
- Some promote discussion of feelings or
THERAPEUTIC COMMUNICATION #3
concerns in more depth.
PROXEMICS
- Other techniques useful in focusing or
Distance zones
clarifying what is being said.
 Intimate (0-18 in)
 Personal (18-36 in)
 - Feedback via making an observation or Nondirective role (broad openings,
presenting reality open-ended questions)
VERBAL COMMUNICATION #2 Directive role (direct yes-or-no
 Avoidance of non-therapeutic questions; usually for clients with
techniques suicidal thoughts, in crisis, or who are
- Advising, belittling, challenging, out of touch with reality)
probing, reassuring
 Interpretation of signals or cues THERAPEUTIC COMMUNICATION SESSION #4
- Overt (clear, direct statements)  Asking for clarification
- Covert (vague, indirect messages)  Addressing client’s

NONVERBAL COMMUNICATION SKILLS #1 ASSERTIVE COMMUNICATION

 Facial expression  Expression of positive and negative
- Expressive feelings/ideas in an open, honest, direct
- Impassive way
- Confusing - Calm, specific, factual statements
 Body language - Focus on “I” statements
- Closed body position  Possible responses
- Open posture - Aggressive
- Passive-aggressive
- Passive
NONVERBAL COMMUNICATION SKILLS #2 - Assertive
 Broken record technique

UNDERSTANDING MEANING, CONTEXT, AND

UNDERSTANDING MEANING, CONTEST, AND SPIRITUALITY OF COMMUNICATION #2
SPIRITUALITY OF COMMUNICATION #1
 Meaning: messages often contain more
meaning than just spoken word.
 Spirituality
- Self-awareness of own spiritual beliefs VERBAL COMMUNICATION
- Need for objectivity and nonjudgmental - Goal of the interview process: to elicit
attitude about client’s beliefs as much data about the client’s health
status as possible
Cultural Considerations
 Consideration assessment Types of Questions:
 Use of a translator who can retain the  Open-ended question
original intent without inserting biases - Used to elicit client’s feelings and
perceptions.
THERAPEUTIC COMMUNICATION SESSION #2 - “How” or “what”
 Initiation of session  Close-ended question
- Introduction - Used to obtain facts and to focus on
- Establishment of contract for specific information.
relationship - “when” or “did”
- Identification of major concern:
THERAPEUTIC COMMUNICATION TECHNIQUES:

REPHRASING
- Helps clarify information the client has
stated