HPR 450 Chapter 6 COMMUNICATION SKILLS INTERPERSONAL COMMUNICATION

HPR 450 Chapter 6 COMMUNICATION SKILLS

INTERPERSONAL COMMUNICATION � Without these effective interpersonal communication skills the TR Process is doomed to failure � Listening � Counseling � Leader communication � Interviewing � Clients with special needs

� Communication skills are used in all parts of our lives � Communication process includes 5 elements � Communicator - Who � Message – Says What � Medium – In What Way � Receiver - To Whom � Feedback – With What Effect

VERBAL COMMUNICATION � Four Factors � Presentation of the material in terms of Vocabulary and Clarity � Speaker’s attitude – Concern and caring � Voice tone and volume - Tone of voice (inflection) � Speaker’s and Receiver’s ability to listen

EFFECTIVE LISTENING SKILLS � Attending – (eye contact, posture, gestures, verbal behavior) � Paraphrasing – restated in similar but fewer words � Clarifying – I’m confused…would you go over that again? � Perception Checking – “You seem to be happy. Is that right? ”

TABLE 6 -1 ATTENTIVE LISTENING USING ACRONYM “SOLER” S − Sit squarely facing the clients. O − Observe an open posture. (arms and legs uncrossed) L − Lean forward toward the client. E − Establish eye contact. R − Relax. Source: Adapted from Egan, G. (2002). The skilled helper: A problem management approach to helping (7 th edition). Pacific Grove, CA: Brooks/ Cole Publishing Company & Townsend, M. C. (2000). Psychiatric mental health nursing: Concepts of care (3 rd edition). Philadelphia: F. A. Davis Company.

VERBAL TECHNIQUES FOR HELPING PROFESSIONALS TO EMPLOY – TABLE 6 -2 � Minimal verbal responses � Informing � Paraphrasing � Summarizing Checking out � Self-disclosing � Focusing � Making observations � Suggesting � Closed questions � Facilitative questions and statements � � � Clarifying Probing � Reflecting � Interpreting � Confronting

� Effective communication in success-failure situations demands appropriate approaches from the leader � Understanding nonverbal communication is a critical skill for Helping professionals because approx 2/3 of communication is nonverbal � Following guidelines may prove to be helpful when communicating with persons with special needs (e. g. , visually and/or hearing impaired) � Interviewing skills are basic for the CTRS

TABLE 6 -3 GENERAL GUIDELINES FOR USING MAJOR VERBAL TECHNIQUES 1. Phrase your response in the same vocabulary that the client uses. 2. Speak slowly enough that the client will understand each word. 3. Use concise rather than rambling statements. 4. Relate the topic introduced by the client to the identified cognitive theme that is of most importance. 5. Talk directly to the client, not about him or her. 6. Send “I” statements to “own” your feelings, and allow the client to reject, accept, or modify your messages. 7. Encourage the client to talk about his or her feelings. 8. Time your responses to facilitate, not block, communication. Adapted from: Okun, B. F. (2002/ Effective helping: Interviewing and counseling techniques (6 th ed. ). Pacific Grove, CA: Brooks/Cole.

TABLE 6 -4 FACILITATIVE QUESTIONS AND STATEMENTS Type Example Observe—to notice what went on or what goes on. “Tell me about yourself. ” “Tell me every detail from the beginning. ” “To what degree do you feel that way? ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -4 FACILITATIVE QUESTIONS AND STATEMENTS (CONT. ) Type Example Describe—to stimulate recall and details of a specific event or experience. “What did you feel at the time? ” “What happened just before? ” “How did he respond to your comment? ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -4 FACILITATIVE QUESTIONS AND STATEMENTS (CONT. ) Type Example Analyze—to review that information for greater understanding. “What is the importance of event? ” “What do you see as the reason? ” “What was your part in it? ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -4 FACILITATIVE QUESTIONS AND STATEMENTS (CONT. ) Type Example Formulate—to restate in a clear, direct way the relationship between thoughts, feelings, and experiences. “Tell me again. ” “What would you say was the problem? ” “Can you tell me the essence of it? ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -4 FACILITATIVE QUESTIONS AND STATEMENTS (CONT. ) Type Example Test—to try out new thoughts, feelings, or behaviors. “What would you do if a situation like that came up again? ” “In what way will this understanding help you in the future? ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -5 BARRIERS TO THERAPEUTIC COMMUNICATION Barriers Non-Therapeutic Examples Giving advice “If I were you…” Giving false reassurance “Don’t worry—everything will be OK. ” Topic jumping (changing the subject) “Let’s wait on that and talk about…” Interrupting “Hold it, hold it!” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -5 BARRIERS TO THERAPEUTIC COMMUNICATION (CONT. ) Barriers Non-Therapeutic Examples Being judgmental “You’re wrong. ” Blaming “It is all your fault. ” Giving directions “Just do what I say. ” Excessive questioning “What is the real reason? ” Challenging “You can’t really hear the devil speaking. ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -5 BARRIERS TO THERAPEUTIC COMMUNICATION (CONT. ) Barriers Expressing disapproval Hurried approaches Closed-mindedness, Stereotyped responses Non-Therapeutic Examples “I don’t approve of that. ” (or frowning) “Will you please hurry up. ” “That’s the only way to see it. ” “Keep your chin up; it won’t be much longer. ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -5 BARRIERS TO THERAPEUTIC COMMUNICATION (CONT. ) Barriers Non-Therapeutic Examples Double messages “Tell me more. ” (While nonverbals show lack of interest. ) Defending or defensive responses Self-preoccupation or daydreaming Patronizing “Don’t blame me; you’re the one with problems. ” “Oh, excuse me; could you repeat that? I didn’t hear what you said. ” “Now, Honey, it will work out. ” Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A. L. Mc. Mahon & P. Price. Hoskins (Eds. ), Comprehensive Psychiatric Nursing (5 th ed. ). St. Louis: Mosby (pp. 121 -142).

TABLE 6 -6 COMMUNICATION WITH CLIENTS WITH SPECIAL NEEDS � Clients Who Are Visually Impaired � Clients Who Are Hearing Impaired � Clients Who Use Wheelchairs � Clients Who Speak a Foreign Language

TABLE 6 -7 TECHNIQUES FOR THE PRODUCTIVE INTERVIEW � Establish rapport � Control the external environment � Wear clothing that conveys the image of a professional and is appropriate for the situation. � Begin by stating and validating with the client the purpose of the interview. � Use a vocabulary on the level of awareness or understanding of the person. Source: Murray, R. B. , & Huelskoetter, M. M. W. (1991). Psychiatric/mental health nursing (3 rd ed. ). Norwalk, CT: Appleton & Lange: pp. 139.

TABLE 6 -7 TECHNIQUES FOR THE PRODUCTIVE INTERVIEW (CONT. ) � Avoid preconceived ideas, prejudices, or biases. � Be precise in what you say, so the meaning is understood. � Avoid asking questions in ways that get only socially acceptable answers. � Be gentle and tactful when asking questions about home like or personal matters. � Be an attentive listener. Source: Murray, R. B. , & Huelskoetter, M. M. W. (1991). Psychiatric/mental health nursing (3 rd ed. ). Norwalk, CT: Appleton & Lange: pp. 139.

TABLE 6 -7 TECHNIQUES FOR THE PRODUCTIVE INTERVIEW (CONT. ) � Carefully observe nonverbal messages for signs of anxiety, frustration, anger, loneliness, or guilt. � Encourage spontaneity. � Ask questions beginning with “What…? ” “Where…? ” “Who…? ” and “When…? ” � Keep data obtained in the interview confidential and share this information only with the appropriate and necessary health team members. � Evaluate the interview. Source: Murray, R. B. , & Huelskoetter, M. M. W. (1991). Psychiatric/mental health nursing (3 rd ed. ). Norwalk, CT: Appleton & Lange: pp. 139.