Chapter 4 Therapeutic Communication Skills Copyright 2010 Delmar

Importance of Communication • Foundation for all patient care • Therapeutic communication skills create

The Communication Cycle • Involves two or more individuals exchanging information • Involves sending

The Communication Cycle ^^ The communication cycle and channels of communication. Copyright © 2010

Four Elements of the Communication Cycle • The sender begins cycle by encoding message

Four Elements of the Communication Cycle • The receiver must decode the meaning of

The Communication Cycle • Listening skills – Active listening involves verifying message from sender

Verbal Communication • Takes place when message is spoken • Sender and receiver must

Verbal Communication • The Five C’s of Communication: – Complete – Clear • •

Verbal Communication • Good communication skills help establish rapport with patients – Call patients

Nonverbal Communication • Body language – Unconscious body movements, gestures, and facial expressions Body

Nonverbal Communication • Body Language – – Expressions that accompany speech Kinesics is study

Nonverbal Communication • Feelings and emotions are communicated through nonverbal means – 70% of

Nonverbal Communication • Facial expression – Eyes reflect feelings – Staring is invasion of

Nonverbal Communication • Posture – Relates to position of body or parts of body

Nonverbal Communication Positive posture and position encourage therapeutic communication >> Copyright © 2010 Delmar,

Nonverbal Communication • Gestures and mannerisms – “Talk” with hands – Enhances spoken word

Congruency in Communication Click Here to play the video Copyright © 2010 Delmar, Cengage

Congruency in Communication • • Verbal and nonverbal messages must agree The meaning of

Congruency in Communication • Perception – Conscious awareness of one’s own feelings and the

Barriers to Therapeutic Communication • Age and gender barriers • Economic barriers • Education

Barriers to Therapeutic Communication • Bias and prejudice barriers • Verbal roadblocks to therapeutic

Defense Mechanisms as Barriers • • • Regression Denial Repression Projection Sublimation • •

Barriers to Therapeutic Communication • Barriers caused by cultural and religious diversity – Caregiving

Barriers to Therapeutic Communication • Human needs as barriers to communication Maslow’s hierarchy of

Establishing Multicultural Communication • The patient must trust the professional • Steps to building

Working with Multicultural and Diverse Patient Populations Click Here to play the video Copyright

Cultural Brokering • Cultural broker serves as a go-between • One who advocates on

Cultural Brokering • Goal of cultural brokering – Increase the capacity of health care

Working with Interpreters • Interpreters do not provide word-for-word equivalence, rather focus on the

Working with Interpreters • A family member may serve as the interpreter • Disadvantage

Interview Techniques • Closed questions – “Are you taking your medications? ” • Open-ended

Point of Care Techniques • Location where the patient and provider or patient and

Community Resources • Need to refer patient to a community resource • Developing a

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Four Elements of the Communication Cycle • The sender begins cycle by encoding message • The message delivered via a channel or mode of communication • • Speaking Listening Gestures or body language Writing Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Four Elements of the Communication Cycle • The receiver must decode the meaning of the message • Feedback takes place after receiver has decoded message sent by sender Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

The Communication Cycle • Listening skills – Active listening involves verifying message from sender – Received message is sent back to sender worded slightly differently Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Verbal Communication • The Five C’s of Communication: – Complete – Clear • • Eye contact enhances clarity Articulate and enunciate Time to process message Message must be heard – Concise – Cohesive – Courteous Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Verbal Communication • Good communication skills help establish rapport with patients – Call patients by full name – Encourage patients to verbalize feelings – Give technical information to patients clearly • Allow patients to make practical application to their health needs Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nonverbal Communication • Body language – Unconscious body movements, gestures, and facial expressions Body language can communicate more than spoken words >> Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nonverbal Communication • Body Language – – Expressions that accompany speech Kinesics is study of body language Body language learned first Body language influenced by primary caregivers and culture Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nonverbal Communication • Feelings and emotions are communicated through nonverbal means – 70% of language is nonverbal – Tone of voice communicates 23% of message – Spoken word communicates 7% of message Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nonverbal Communication • Facial expression – Eyes reflect feelings – Staring is invasion of privacy – Cultural influences affect facial expressions • Personal space – Comfortable personal space – Handled differently by various cultures – Explain procedures that will be invasive Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nonverbal Communication • Posture – Relates to position of body or parts of body – Involves at least half the body • Position – Face-to-face communication – Should enable observation of verbal and nonverbal cues Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nonverbal Communication • Gestures and mannerisms – “Talk” with hands – Enhances spoken word • Touch – Appropriate touch is therapeutic – Not all patients are comfortable with touch Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Congruency in Communication • • Verbal and nonverbal messages must agree The meaning of mixed messages Clustering groups of nonverbal messages Masking conceals true feeling or message Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Congruency in Communication • Perception – Conscious awareness of one’s own feelings and the feelings of others – Sense another’s attitudes, moods, and feelings – Follow perceived assessments with verbal validation – Easily misinterpreted Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Defense Mechanisms as Barriers • • • Regression Denial Repression Projection Sublimation • • Displacement Compensation Rationalization Undoing Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Establishing Multicultural Communication • The patient must trust the professional • Steps to building trust include: – – – Risk/trust Conveying empathy Showing respect Being genuine Active listening Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Cultural Brokering • Cultural broker serves as a go-between • One who advocates on behalf of another individual or group within the health care community Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Cultural Brokering • Goal of cultural brokering – Increase the capacity of health care and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems • Cultural brokers may assume the role of medical interpreter Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Working with Interpreters • Interpreters do not provide word-for-word equivalence, rather focus on the accurate expression of equivalent meaning • Remember to speak directly to the patient, not to the interpreter Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Working with Interpreters • A family member may serve as the interpreter • Disadvantage of a family member serving as interpreter – They may not understand medical terminology – It would be very difficult for a family member to share a poor prognosis or a life-threatening diagnosis Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Interview Techniques • Closed questions – “Are you taking your medications? ” • Open-ended questions – “How are you coming along with your diet? ” • Indirect statements – “Tell me what you’ve been doing since your retirement. ” Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.