Therapeutic Communications 1 Objective o Distinguish between Therapeutic

Therapeutic Communications 1

Objective: o Distinguish between Therapeutic and Non. Therapeutic communication 2

Listening sit when communicating with the patient q be alert & relaxed and take sufficient time q maintain eye contact q indicate that you are paying attention to what the patient is saying q

Silence o o take the time to wait for the patient to initiate or to continue speaking allow the patient and health care worker time to reflect on what has been said and to collect thoughts

Offering Self: Can I help in some way? I’ll be here until 4: 14. I am interested in what you have to say. o shows caring and concern o shows readiness to help

Reflection: repeating what the patient has said o validation that this is what was meant o encourages further verbalization

Encouraging Elaboration: Tell me how that felt. o used to elicit information about a subject o helps the patient clarify unclear thoughts or ideas

General Leading Statements: Go on. I see. And then? Tell me about it. o used to get interaction started o encourages patient to continue or elaborate

Giving Information: The test results take 48 hours to return to us. My purpose here is……. . (this line is answered 24 hrs a day) o Informs the patient of specific information relevant to their health care o Requires feedback to make sure the patient receives the correct information

Open Ended Questions: “Tell me about your day, ” rather than, “How was your day? ” Is there something you would like to talk about? Where would you like to begin? o Encourages elaboration rather than a 1 or 2 word answer o Creates an inviting atmosphere for sharing thoughts, and feelings

Non-Therapeutic Communications 11

Don’t use clichés: Everything will be O. K. You don’t need to worry about that. o offers false reassurance o can be interpreted as there is no cause for concern

Don’t use questions beginning with Why? or How? o requesting an explanation o puts patient or co-worker on the defensive

Don’t give advice o o denies the patient the right to make their own decisions increases patient’s dependence on health care providers

Don’t keep changing the subject o o may keep the patient from talking about what is a concern to him/her indicates that the health care worker is ignoring the patient

Don’t use judgmental comments: You aren’t acting very grown up, How do you think they would feel if they saw you like this? o imposes the health care worker’s feelings on the patient o belittles what the patient is feeling

Gender Bias o o o Words used often reflect a gender role bias: All nurses are female. Gender roles have changed in the past ten years To eliminate bias, avoid referring to doctors as male and nurses as female – address the person by name or title

Activity #6 o o o Identify the communication techniques used with each patient decide if it is therapeutic or non-therapeutic If you choose non-therapeutic, please write two alternative responses. 18

Activity: Therapeutic and Non-therapeutic Activity o Situation I Mrs. James, 20 years old, was in a car accident three days ago. In addition to having a fractured leg, she has multiple bruises and lacerations to her face. She comes to Physical Therapy to learn to walk with crutches. She tells the Physical Therapist, “I won’t be able to face my friends. I look like a freak. ” The Physical Therapist replies, “Don’t worry about such things. You’ll heal fine. ” Type of technique Cliches Therapeutic or non-therapeutic Revisions: Go on. Offering general leading comments Tell me more about how you are feeling. Encouraging patient to elaborate

o Situation II Mr. Smith, 40 years old, was admitted on the evening shift with a urinary tract infection. As you are making rounds at midnight, you notice that he is awake. When you ask if you can do anything for him, he responds, “I can’t seem to go to sleep. My wife was just diagnosed with cancer, and I am so worried about it, I am having a hard time sleeping. ” The nurse says, “I think it is time for your vital signs now. Let me get the IVAC and I will get those right away. ” Type of technique: Changing the subject Therapeutic or non-therapeutic: Non-therapeutic Revisions: “I am here to listen if you would like to talk about it. ” Offering self Diagnosed with cancer…. Reflection

o Situation III You are working in a pharmacy. A patient comes in with a prescription to be filled. As you check the prescription, she says, “The Doctor told me what this medication is for but I didn’t understand him. ” After checking with the pharmacist, you tell her; “This medication is to help lower your blood pressure. It should be taken once a day at the same time each day. ” Type of technique: Offering information Therapeutic or non-therapeutic: therapeutic Revisions: No revisions needed