Principles techniques and elements of therapeutic communication 1
![Principles, techniques, and elements of therapeutic communication 1 Principles, techniques, and elements of therapeutic communication 1](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-1.jpg)
![Therapeutic Communication • Therapeutic communication is the use of communication for the purpose of Therapeutic Communication • Therapeutic communication is the use of communication for the purpose of](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-2.jpg)
![Therapeutic Communication • Interactive process between nurse, client • Helps client overcome temporary stress Therapeutic Communication • Interactive process between nurse, client • Helps client overcome temporary stress](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-3.jpg)
![Therapeutic Communication Characteristics • Is purposeful and goal-directed • Has well-defined boundaries • Is Therapeutic Communication Characteristics • Is purposeful and goal-directed • Has well-defined boundaries • Is](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-4.jpg)
![The Elements of Therapeutic Communication 1. • Empathy: An emotional linkage between two or The Elements of Therapeutic Communication 1. • Empathy: An emotional linkage between two or](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-5.jpg)
![• Empathizing o Empathy is process • People feel with one another • • Empathizing o Empathy is process • People feel with one another •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-6.jpg)
![• Empathy o Four phases of therapeutic empathizing • Identification • Incorporation • • Empathy o Four phases of therapeutic empathizing • Identification • Incorporation •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-7.jpg)
![Outcomes of empathy • Promotes understanding of the client’s feelings and condition. • Enables Outcomes of empathy • Promotes understanding of the client’s feelings and condition. • Enables](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-8.jpg)
![2. Trust: The client’s belief that the nurse will behave predictably and competently while 2. Trust: The client’s belief that the nurse will behave predictably and competently while](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-9.jpg)
![• End the session on time. • Return when you say you will. • End the session on time. • Return when you say you will.](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-10.jpg)
![Establish Trust • Establishing rapport o Include adolescent in discussion o Listen more than Establish Trust • Establishing rapport o Include adolescent in discussion o Listen more than](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-11.jpg)
![3. Honesty: The ability to be truthful, frank, and sincere Behaviors of the Nurse 3. Honesty: The ability to be truthful, frank, and sincere Behaviors of the Nurse](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-12.jpg)
![4. Validation: Listening to the client and responding congruently in order to be sure 4. Validation: Listening to the client and responding congruently in order to be sure](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-13.jpg)
![5. Caring: The level of emotional involvement between the nurse and the client. Behaviors 5. Caring: The level of emotional involvement between the nurse and the client. Behaviors](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-14.jpg)
![6. Active listening: Hearing and interpreting language, noticing nonverbal and paraverbal enhancements, and identifying 6. Active listening: Hearing and interpreting language, noticing nonverbal and paraverbal enhancements, and identifying](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-15.jpg)
![• Attentive listening o Mindful listening o Paying attention to verbal, nonverbal o • Attentive listening o Mindful listening o Paying attention to verbal, nonverbal o](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-16.jpg)
![• Understanding the feelings behind the facts. • Noticing discrepancies between facts and • Understanding the feelings behind the facts. • Noticing discrepancies between facts and](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-17.jpg)
![Blocks to Attentive Listening 1. 2. 3. 4. 5. 6. 7. Rehearsing Being concerned Blocks to Attentive Listening 1. 2. 3. 4. 5. 6. 7. Rehearsing Being concerned](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-18.jpg)
![Skills to achieve the maximum of listening: 1. Attending • Physical attending o Face Skills to achieve the maximum of listening: 1. Attending • Physical attending o Face](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-19.jpg)
![2. Silence • Using silence o Encouraging the client to communicate o Allowing client 2. Silence • Using silence o Encouraging the client to communicate o Allowing client](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-20.jpg)
![3. Reflection • Reflecting o Repeating the client’s message • Verbal or nonverbal o 3. Reflection • Reflecting o Repeating the client’s message • Verbal or nonverbal o](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-21.jpg)
![4. Just the Facts • Imparting information o Supplying additional data o Not constructive 4. Just the Facts • Imparting information o Supplying additional data o Not constructive](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-22.jpg)
![5. Deflection • Avoiding self-disclosure o Deflect a request for self-disclosure • Honesty • 5. Deflection • Avoiding self-disclosure o Deflect a request for self-disclosure • Honesty •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-23.jpg)
![6. Clarification • Clarifying o Attempt to understand client’s statement o Ask client to 6. Clarification • Clarifying o Attempt to understand client’s statement o Ask client to](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-24.jpg)
![7. Question and Define • Questioning o Very direct way of speaking with clients 7. Question and Define • Questioning o Very direct way of speaking with clients](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-25.jpg)
![8. Pinpoint and Link • Pinpointing o Calls attention to certain kinds of statements 8. Pinpoint and Link • Pinpointing o Calls attention to certain kinds of statements](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-26.jpg)
![9. Giving Feedback • Nurse share reaction to what client said • Give in 9. Giving Feedback • Nurse share reaction to what client said • Give in](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-27.jpg)
![10. Focus Feedback • • On behavior, observations, description On more-or-less, rather than either/or 10. Focus Feedback • • On behavior, observations, description On more-or-less, rather than either/or](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-28.jpg)
![11. Confronting • Deliberate invitation to examine some aspect of personal behavior that indicates 11. Confronting • Deliberate invitation to examine some aspect of personal behavior that indicates](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-29.jpg)
![Six Skills in Confronting • • • Use of personal statements Use of relationship Six Skills in Confronting • • • Use of personal statements Use of relationship](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-30.jpg)
![12. Summarize and Process • Summarizing o Highlighting the main ideas expressed o Conveys 12. Summarize and Process • Summarizing o Highlighting the main ideas expressed o Conveys](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-31.jpg)
![Therapeutic Communication Mistakes • Common mistakes o Giving advice o Minimizing or discounting feelings Therapeutic Communication Mistakes • Common mistakes o Giving advice o Minimizing or discounting feelings](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-32.jpg)
![Barriers and threats to effective Communication • Failure to listen • Improperly decoding intended Barriers and threats to effective Communication • Failure to listen • Improperly decoding intended](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-33.jpg)
![The Therapeutic Relationship • Growth-facilitating process o Help client manage problems in living • The Therapeutic Relationship • Growth-facilitating process o Help client manage problems in living •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-34.jpg)
![Therapeutic Relationship Characteristics • Characteristics of therapeutic relationship o Intellectual and emotional bond • Therapeutic Relationship Characteristics • Characteristics of therapeutic relationship o Intellectual and emotional bond •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-35.jpg)
![Therapeutic Relationship Phases • Preinteraction 1. Introductory 2. Working: stage 1 and stage 2 Therapeutic Relationship Phases • Preinteraction 1. Introductory 2. Working: stage 1 and stage 2](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-36.jpg)
![1. Introductory Phase • Preinteraction phase • Introductory phase o Orientation, pretherapeutic phase o 1. Introductory Phase • Preinteraction phase • Introductory phase o Orientation, pretherapeutic phase o](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-37.jpg)
![• By end of this phase client begins to o Develop trust in • By end of this phase client begins to o Develop trust in](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-38.jpg)
![2. Working Phase Stages • Stage One o Exploring and understanding thoughts and feelings 2. Working Phase Stages • Stage One o Exploring and understanding thoughts and feelings](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-39.jpg)
![• Stage two o Facilitate and take action o Collaborate o Make decisions • Stage two o Facilitate and take action o Collaborate o Make decisions](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-40.jpg)
![3. Termination Phase • • Difficult, ambivalent Summarizing Termination discussions Allow time for client 3. Termination Phase • • Difficult, ambivalent Summarizing Termination discussions Allow time for client](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-41.jpg)
![Developing the Therapeutic Relationship • Set mutual goals with client • Discuss outcomes • Developing the Therapeutic Relationship • Set mutual goals with client • Discuss outcomes •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-42.jpg)
![Skills for the Therapeutic Relationship • • Listen actively Help identify the client’s feelings Skills for the Therapeutic Relationship • • Listen actively Help identify the client’s feelings](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-43.jpg)
![Communication Techniques Working with Children and Families • • Accepting Broad openings Clarifying Focusing Communication Techniques Working with Children and Families • • Accepting Broad openings Clarifying Focusing](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-44.jpg)
![Developmental Considerations • Establish rapport with children o Sit or lower self to child’s Developmental Considerations • Establish rapport with children o Sit or lower self to child’s](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-45.jpg)
![Conclusion • Nurse’s role requires communication skills • Effective communication large role o Ability Conclusion • Nurse’s role requires communication skills • Effective communication large role o Ability](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-46.jpg)
- Slides: 46
![Principles techniques and elements of therapeutic communication 1 Principles, techniques, and elements of therapeutic communication 1](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-1.jpg)
Principles, techniques, and elements of therapeutic communication 1
![Therapeutic Communication Therapeutic communication is the use of communication for the purpose of Therapeutic Communication • Therapeutic communication is the use of communication for the purpose of](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-2.jpg)
Therapeutic Communication • Therapeutic communication is the use of communication for the purpose of creating a beneficial outcome for the client. • Ruesch (1961), who originated the term therapeutic communication, stated that the purpose is to improve the client’s ability to function. • Furthermore, therapeutic communication facilitates the establishment of the nurse-client relationship and fulfills the purposes of nursing. 2
![Therapeutic Communication Interactive process between nurse client Helps client overcome temporary stress Therapeutic Communication • Interactive process between nurse, client • Helps client overcome temporary stress](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-3.jpg)
Therapeutic Communication • Interactive process between nurse, client • Helps client overcome temporary stress o To get along with other people o Adjust to the unalterable o Overcome psychological blocks • Established with purpose of helping client • Nurse responds to content o Verbal, nonverbal
![Therapeutic Communication Characteristics Is purposeful and goaldirected Has welldefined boundaries Is Therapeutic Communication Characteristics • Is purposeful and goal-directed • Has well-defined boundaries • Is](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-4.jpg)
Therapeutic Communication Characteristics • Is purposeful and goal-directed • Has well-defined boundaries • Is client-focused • Is nonjudgmental • Uses well-planned, selected techniques 4
![The Elements of Therapeutic Communication 1 Empathy An emotional linkage between two or The Elements of Therapeutic Communication 1. • Empathy: An emotional linkage between two or](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-5.jpg)
The Elements of Therapeutic Communication 1. • Empathy: An emotional linkage between two or more people through which feelings are communicated; • involves trying to imagine what it must be like to be in another person’s situation Behaviors of the Nurse • Verbal comments: “This must make you feel sad. ” • Nonverbal actions: • A nod of the head to indicate understanding. • Mirroring the client’s facial expression in a genuine way. 5
![Empathizing o Empathy is process People feel with one another • Empathizing o Empathy is process • People feel with one another •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-6.jpg)
• Empathizing o Empathy is process • People feel with one another • Embrace attitude of person who is speaking • Grasp idea that what client has to say important o NOT synonymous with sympathy o Interprets clients feelings without inserting own
![Empathy o Four phases of therapeutic empathizing Identification Incorporation • Empathy o Four phases of therapeutic empathizing • Identification • Incorporation •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-7.jpg)
• Empathy o Four phases of therapeutic empathizing • Identification • Incorporation • Reverberation • Detachment o On guard against over-distancing or burnout
![Outcomes of empathy Promotes understanding of the clients feelings and condition Enables Outcomes of empathy • Promotes understanding of the client’s feelings and condition. • Enables](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-8.jpg)
Outcomes of empathy • Promotes understanding of the client’s feelings and condition. • Enables the nurse and client to relate better. • Provides the client with clues that the nurse is following and understanding what is being said. 8
![2 Trust The clients belief that the nurse will behave predictably and competently while 2. Trust: The client’s belief that the nurse will behave predictably and competently while](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-9.jpg)
2. Trust: The client’s belief that the nurse will behave predictably and competently while respecting the client’s needs Behaviors of the Nurse • Ensure confidentiality. • Be consistent. • Do exactly what you say you will do for the client. • Arrive on time. 9
![End the session on time Return when you say you will • End the session on time. • Return when you say you will.](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-10.jpg)
• End the session on time. • Return when you say you will. • Be consistently friendly, open, and honest. Outcomes • Provides the basis for progress during future encounters. • Sets up the foundation of therapeutic relationship. • Makes the client feel comfortable with the nurse, rather than guarded or afraid. 10
![Establish Trust Establishing rapport o Include adolescent in discussion o Listen more than Establish Trust • Establishing rapport o Include adolescent in discussion o Listen more than](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-11.jpg)
Establish Trust • Establishing rapport o Include adolescent in discussion o Listen more than you talk o Avoid distractions o Be truthful with the child • Establishing trust o Follow through with promises o Respect confidentiality o Be truthful, even if it isn’t what they want
![3 Honesty The ability to be truthful frank and sincere Behaviors of the Nurse 3. Honesty: The ability to be truthful, frank, and sincere Behaviors of the Nurse](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-12.jpg)
3. Honesty: The ability to be truthful, frank, and sincere Behaviors of the Nurse • Provide realistic reassurance. • Avoid false reassurance. • Develop insight into the way your feelings and reactions affect the client. • Accept yourself. Outcomes • Promotes the development of trust. • Enables the nurse to gain personal insight. Consequently, behavior with the client can be modified as needed. 12
![4 Validation Listening to the client and responding congruently in order to be sure 4. Validation: Listening to the client and responding congruently in order to be sure](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-13.jpg)
4. Validation: Listening to the client and responding congruently in order to be sure that the nurse and client have the same understanding of a problem or issue Behaviors of the Nurse: Verbal comments: • “So you are saying that. . . ” • “Let me be sure I understand what you are saying. ” • “Tell me what you understand about what I just said. ” Outcomes: • Clarifies communication. • Helps the client to feel accepted, respected, and understood. 13
![5 Caring The level of emotional involvement between the nurse and the client Behaviors 5. Caring: The level of emotional involvement between the nurse and the client. Behaviors](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-14.jpg)
5. Caring: The level of emotional involvement between the nurse and the client. Behaviors of the Nurse: Nonverbal actions: • Seeking the client out each day. • Spending quality time with the client. • Paying attention to the client’s needs. • Using tactile messages, such as a pat on the back, to show support. Outcomes: • Makes the client feel accepted. • Provides the client with the knowledge that the nurse is willing to help. 14
![6 Active listening Hearing and interpreting language noticing nonverbal and paraverbal enhancements and identifying 6. Active listening: Hearing and interpreting language, noticing nonverbal and paraverbal enhancements, and identifying](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-15.jpg)
6. Active listening: Hearing and interpreting language, noticing nonverbal and paraverbal enhancements, and identifying underlying feelings. Behaviors of the Nurse: • Taking time to listen. • Giving the client your undivided attention. • Making eye contact. • Responding to verbal and nonverbal leads, clues, and signals from the client. • Analyzing and validating throughout the conversation. • Suspending judgment. • Listening between the lines. 15
![Attentive listening o Mindful listening o Paying attention to verbal nonverbal o • Attentive listening o Mindful listening o Paying attention to verbal, nonverbal o](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-16.jpg)
• Attentive listening o Mindful listening o Paying attention to verbal, nonverbal o Noting congruence o Absorbing content and feeling o Listening for key themes o Be aware of own biases o Highly developed skill
![Understanding the feelings behind the facts Noticing discrepancies between facts and • Understanding the feelings behind the facts. • Noticing discrepancies between facts and](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-17.jpg)
• Understanding the feelings behind the facts. • Noticing discrepancies between facts and feelings. • Noticing things omitted such as topics that the client should be discussing but avoids. • Using communication principles and techniques to be a sounding board. Outcomes: • Promotes understanding of the client. • Allows the client to express self more freely. • Helps the client gain a better understanding of the problem(s). • Promotes problem solving by the client. • Enhances the client’s self-esteem. 17
![Blocks to Attentive Listening 1 2 3 4 5 6 7 Rehearsing Being concerned Blocks to Attentive Listening 1. 2. 3. 4. 5. 6. 7. Rehearsing Being concerned](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-18.jpg)
Blocks to Attentive Listening 1. 2. 3. 4. 5. 6. 7. Rehearsing Being concerned with oneself Assuming Judging Identifying Getting off track Filtering
![Skills to achieve the maximum of listening 1 Attending Physical attending o Face Skills to achieve the maximum of listening: 1. Attending • Physical attending o Face](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-19.jpg)
Skills to achieve the maximum of listening: 1. Attending • Physical attending o Face the person squarely o Adopt an open posture o Lean toward the person o Maintain good eye contact o Try to be relatively relaxed
![2 Silence Using silence o Encouraging the client to communicate o Allowing client 2. Silence • Using silence o Encouraging the client to communicate o Allowing client](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-20.jpg)
2. Silence • Using silence o Encouraging the client to communicate o Allowing client time to ponder what has been said o Allow client time to collect thoughts o Allow client time to consider alternatives o Look interested o Uncomfortable silence should be broken • Analyzed
![3 Reflection Reflecting o Repeating the clients message Verbal or nonverbal o 3. Reflection • Reflecting o Repeating the client’s message • Verbal or nonverbal o](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-21.jpg)
3. Reflection • Reflecting o Repeating the client’s message • Verbal or nonverbal o Reflecting content repeats client’s statement • May be misused, overused • Use judiciously o Reflecting feelings • Verbalizing implied feelings in client’s comment o Encourages client to clarify
![4 Just the Facts Imparting information o Supplying additional data o Not constructive 4. Just the Facts • Imparting information o Supplying additional data o Not constructive](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-22.jpg)
4. Just the Facts • Imparting information o Supplying additional data o Not constructive to withhold useful information o Line between information and advice o Avoid personal, social information o Client participation in decision making positive mental health outcomes • Take in and understand information • Educated empowered client
![5 Deflection Avoiding selfdisclosure o Deflect a request for selfdisclosure Honesty 5. Deflection • Avoiding self-disclosure o Deflect a request for self-disclosure • Honesty •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-23.jpg)
5. Deflection • Avoiding self-disclosure o Deflect a request for self-disclosure • Honesty • Benign curiosity • Refocusing • Interpretation • Clarification • Feedback and limit setting o Assess and evaluate responses
![6 Clarification Clarifying o Attempt to understand clients statement o Ask client to 6. Clarification • Clarifying o Attempt to understand client’s statement o Ask client to](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-24.jpg)
6. Clarification • Clarifying o Attempt to understand client’s statement o Ask client to give an example • Paraphrasing o Nurse assimilates or restates in own words o Fives nurse opportunity to test understanding • Checking perceptions o Sharing how one person perceives another
![7 Question and Define Questioning o Very direct way of speaking with clients 7. Question and Define • Questioning o Very direct way of speaking with clients](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-25.jpg)
7. Question and Define • Questioning o Very direct way of speaking with clients o Open-ended questions focuses the topic o Close question limits choice of responses o Careful not to ask questions that steer answer • Structuring o Attempt to create order, establish guidelines o Define parameters of nurse-client relationship
![8 Pinpoint and Link Pinpointing o Calls attention to certain kinds of statements 8. Pinpoint and Link • Pinpointing o Calls attention to certain kinds of statements](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-26.jpg)
8. Pinpoint and Link • Pinpointing o Calls attention to certain kinds of statements • Relationships o Point to inconsistencies o Similarities, differences • Linking o Nurse responds to client • Ties together two events, experiences, feelings • Connect past experiences with current behaviors
![9 Giving Feedback Nurse share reaction to what client said Give in 9. Giving Feedback • Nurse share reaction to what client said • Give in](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-27.jpg)
9. Giving Feedback • Nurse share reaction to what client said • Give in a way that does not threaten client • Risk of client experiencing feedback o Personal rejection • Nurses should be open, receptive to cues
![10 Focus Feedback On behavior observations description On moreorless rather than eitheror 10. Focus Feedback • • On behavior, observations, description On more-or-less, rather than either/or](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-28.jpg)
10. Focus Feedback • • On behavior, observations, description On more-or-less, rather than either/or On here-and-now: what is said, not why Sharing of information, ideas Exploration of alternatives Value to client Amount of information client able to use Appropriate time and place
![11 Confronting Deliberate invitation to examine some aspect of personal behavior that indicates 11. Confronting • Deliberate invitation to examine some aspect of personal behavior that indicates](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-29.jpg)
11. Confronting • Deliberate invitation to examine some aspect of personal behavior that indicates discrepancy between actions and words • Informational confrontation o Describes visible behavior • Interpretive confrontation o Draws inferences about the meaning of behavior
![Six Skills in Confronting Use of personal statements Use of relationship Six Skills in Confronting • • • Use of personal statements Use of relationship](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-30.jpg)
Six Skills in Confronting • • • Use of personal statements Use of relationship statements Use of behavior descriptions Use of description of personal feelings Use of responses aimed at understanding Use of constructive feedback skills
![12 Summarize and Process Summarizing o Highlighting the main ideas expressed o Conveys 12. Summarize and Process • Summarizing o Highlighting the main ideas expressed o Conveys](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-31.jpg)
12. Summarize and Process • Summarizing o Highlighting the main ideas expressed o Conveys understanding o Reviews main themes of conversation o Use at different times during interaction o Don’t rush to summarize • Processing o Direct attention to interpersonal dynamics
![Therapeutic Communication Mistakes Common mistakes o Giving advice o Minimizing or discounting feelings Therapeutic Communication Mistakes • Common mistakes o Giving advice o Minimizing or discounting feelings](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-32.jpg)
Therapeutic Communication Mistakes • Common mistakes o Giving advice o Minimizing or discounting feelings o Deflecting o Interrogating o Sparring ﺗﺸﺘﻴﺖ ﺍﺳﺘﺠﻮﺍﺏ ﺍﻟﺴﺠﺎﻝ
![Barriers and threats to effective Communication Failure to listen Improperly decoding intended Barriers and threats to effective Communication • Failure to listen • Improperly decoding intended](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-33.jpg)
Barriers and threats to effective Communication • Failure to listen • Improperly decoding intended message • Placing the nurse’s needs above client’s
![The Therapeutic Relationship Growthfacilitating process o Help client manage problems in living The Therapeutic Relationship • Growth-facilitating process o Help client manage problems in living •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-34.jpg)
The Therapeutic Relationship • Growth-facilitating process o Help client manage problems in living • More effectively • Develop unused, underused opportunities fully o Help client become better at helping self • May develop over weeks or within minutes • Influenced by nurse and client o Personal and professional characteristics
![Therapeutic Relationship Characteristics Characteristics of therapeutic relationship o Intellectual and emotional bond Therapeutic Relationship Characteristics • Characteristics of therapeutic relationship o Intellectual and emotional bond •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-35.jpg)
Therapeutic Relationship Characteristics • Characteristics of therapeutic relationship o Intellectual and emotional bond • Focused on client o Respects client as individual o Respects client confidentiality o Focuses on client’s well-being o Based on mutual trust, respect, acceptance
![Therapeutic Relationship Phases Preinteraction 1 Introductory 2 Working stage 1 and stage 2 Therapeutic Relationship Phases • Preinteraction 1. Introductory 2. Working: stage 1 and stage 2](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-36.jpg)
Therapeutic Relationship Phases • Preinteraction 1. Introductory 2. Working: stage 1 and stage 2 3. Termination
![1 Introductory Phase Preinteraction phase Introductory phase o Orientation pretherapeutic phase o 1. Introductory Phase • Preinteraction phase • Introductory phase o Orientation, pretherapeutic phase o](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-37.jpg)
1. Introductory Phase • Preinteraction phase • Introductory phase o Orientation, pretherapeutic phase o Nurse and client observe each other o Open relationship o Clarify problem o Structure and formulate contract o Client may display resistive behaviors
![By end of this phase client begins to o Develop trust in • By end of this phase client begins to o Develop trust in](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-38.jpg)
• By end of this phase client begins to o Develop trust in nurse o View nurse as honest, open, concerned o Believe nurse will try to understand, respect o Believe nurse will respect client confidentiality o Feel comfortable talking about feelings o Understand purpose of relationship, roles o Feel an active participant in plan
![2 Working Phase Stages Stage One o Exploring and understanding thoughts and feelings 2. Working Phase Stages • Stage One o Exploring and understanding thoughts and feelings](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-39.jpg)
2. Working Phase Stages • Stage One o Exploring and understanding thoughts and feelings o Empathetic listening and responding o Respect, genuineness o Concreteness o Reflecting, paraphrasing, clarifying, confronting o Intensity of interaction increases
![Stage two o Facilitate and take action o Collaborate o Make decisions • Stage two o Facilitate and take action o Collaborate o Make decisions](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-40.jpg)
• Stage two o Facilitate and take action o Collaborate o Make decisions o Provide support o Offer options
![3 Termination Phase Difficult ambivalent Summarizing Termination discussions Allow time for client 3. Termination Phase • • Difficult, ambivalent Summarizing Termination discussions Allow time for client](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-41.jpg)
3. Termination Phase • • Difficult, ambivalent Summarizing Termination discussions Allow time for client adjustment to independence
![Developing the Therapeutic Relationship Set mutual goals with client Discuss outcomes Developing the Therapeutic Relationship • Set mutual goals with client • Discuss outcomes •](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-42.jpg)
Developing the Therapeutic Relationship • Set mutual goals with client • Discuss outcomes • Many ways of helping do not require training
![Skills for the Therapeutic Relationship Listen actively Help identify the clients feelings Skills for the Therapeutic Relationship • • Listen actively Help identify the client’s feelings](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-43.jpg)
Skills for the Therapeutic Relationship • • Listen actively Help identify the client’s feelings Be empathetic, honest, genuine, and credible Use ingenuity Be aware of cultural differences Maintain confidentiality Know your role and your limitations
![Communication Techniques Working with Children and Families Accepting Broad openings Clarifying Focusing Communication Techniques Working with Children and Families • • Accepting Broad openings Clarifying Focusing](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-44.jpg)
Communication Techniques Working with Children and Families • • Accepting Broad openings Clarifying Focusing Observations Reflection Summarizing Active listening Collaborating Exploring Giving recognition Offering self Restatement or paraphrasing • Validating perceptions • • •
![Developmental Considerations Establish rapport with children o Sit or lower self to childs Developmental Considerations • Establish rapport with children o Sit or lower self to child’s](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-45.jpg)
Developmental Considerations • Establish rapport with children o Sit or lower self to child’s eye level o Note what child is playing with or reading o If appropriate, agree with child/share feelings o Compliment a physical features, activity o Use calm tone of voice, appropriate language o Pace discussion, procedure in nonhurried manner o Preschoolers have limited concept of time
![Conclusion Nurses role requires communication skills Effective communication large role o Ability Conclusion • Nurse’s role requires communication skills • Effective communication large role o Ability](https://slidetodoc.com/presentation_image/caf50ca8f604fdef52d7fdc0de437c01/image-46.jpg)
Conclusion • Nurse’s role requires communication skills • Effective communication large role o Ability to deliver highest quality of care • Nurse needs to be understood • Nurse needs to understand messages • Strong verbal, written communication skills • Monitor own nonverbal communication
Prehospital emergency care 11th edition
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Introduction of therapeutic communication
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