Therapeutic CommunicationNursing Concepts

C. Calzolari

Learner’s Objectives:

Define Therapeutic Communication. Describe the importance of therapeutic communication in the

nursing process. Explain rapport and its importance in nursing. Differentiate between verbal and nonverbal communication.

Give examples of each. Discuss factors that influence the effectiveness of

communication. Demonstrate the interviewing and communication skills of

questioning, therapeutic silence, and clarifying. Describe communication techniques used with special

situations.

What is Therapeutic Communication?

Patient- Centered Communication Focuses on the Patient The goal is to promote a greater understanding of

patient’s needs, concerns and feelings. The nurse helps the patient explore their own thoughts &

feelings, encourages expression of them, and avoids barriers to communication.

Why is it IMPORTANT?

Tell me…

The Approach

The nurse who is using therapeutic communication will:

Refer to handout

Components of Communication

Types of Communication

Verbal

Non-Verbal

Should be CONGRUENT

Verbal Communication

Sharing information through the written or spoken word

Verbal Barriers Neeb’s book, pp. 21-23

False Reassurance/Social Clichés Minimizing/Belittling Asking “WHY?” Advising Agreeing or Disagreeing Closed-ended Questions Providing the Answer with a Question Changing the Subject Approving or Disapproving

Non –Verbal Communication

Sharing information without using words or language

It expresses emotions and attitudes, as well as enhancing what is being expressed verbally.

Personal Space See FUNDAMENTALS Book, p. 117 for cultural differences regarding personal space

Eye Contact

Body Movements

Personal Appearance and Grooming

Therapeutic Use of Touch

Factors Influencing Communication

Attention Culture & Ethnicity Age Gender Social Factors

Difficult Client Behavior

More on Behavior…

Passivity Aggressiveness Assertiveness

“You make me angry when you don’t help.”

Using Unbiased Language When Documenting Client Behaviors

The nurse objectively describes eye contact, rather than applying judgments. For example, “The client looks at the floor when speaking” is descriptive and nonjudgmental. (A judgmental statement such as “good eye contact” implies that all clients should behave like most Western Europeans or Caucasian Americans.)

THERAPEUTIC COMMUNICATION TECHNIQUES

THERAPEUTIC COMMUNICATION TECHNIQUES Interviews Offering Self Using Empathy Closed vs. Open Ended Questions (Handout) Use of Silence Clarification Reflection/Repeating/Parroting Paraphrasing Summarizing Using Unfinished Statements Giving Information Stating Implied Thoughts and Feelings

Communicating in Special Situations

Communicating With Different Age Levels Communicating With the Client Who Has Sensory

Problems The Unconscious Client The Person With Aphasia The Client Who Is Not Able or Who Refuses to Speak The Client Who Speaks a Different Language The Person Who is Anxious The Person with Severe Mental Illness

FACILITATING COMMUNICATION IN HEALTHCARE

Nurses facilitate communication between clients and members of the nursing team in various ways

Key Points

Effective communication is the cornerstone to competent nursing care. This is true in any setting.