Therapeutic Communication

THERAPEUTIC COMMUNICATION TECHNIQUES 1. Using silence – utilizing absence of communication 2. Accepting – giving indication of reception; indicating that the nurse has hear and is willing to hear what the client says. “Yes” “Uh hmm” “I follow what you said” 3. Giving recognition – acknowledging indicating awareness. “Good morning, Mr S.” “ I notice that you combed your hair” 4. Offering self – making oneself available; introducing self and identifying relationship. “I’ll sit with you awhile” I’ll stay here with you” 5. Giving Broad OpeningsOpenings- allowing the patient to take the initiative in introducing the topic; using open-ended questions that provide opportunity for the client to introduce topic. “Is there something you would like to talk about?” “What are you thinking about?” “Where would you like to begin?” 6. Offering General Leads…giving Leads…giving encouragement to continue. “Go on.” “And then?” “Tell me about it.” 7. Placing the Event in Time or in Sequence… Sequence… clarifying the relationship of events in time.; assessing time frame and sequence of an event over time. “Was this before or after…?” “When did this happen?” 8. Making Observations…verbalizing Observations…verbalizing what is perceived; verbalizing what nurses sees in client’s appearance and behaviors “You appear tense.” “I notice that you’re biting your lips.” “It makes me uncomfortable when you… 9. Encouraging Description of Perceptions – asking the patient to verbalize what he perceives; having the client describe his/her view of an event or experience. “Tell me when you feel anxious” “What is happening” “ What does the voice seem to be saying” 10. Encouraging Comparison – asking that similarities and differences be noted. “Was this something like…? “Have you had similar experience?” 11. 11. Restating – repeating the main idea expressed. Patient: “I cant sleep. I stay awake all night” Nurse: “You have difficulty sleeping?”

12. 12. Reflecting – directing back to the patient questions, feelings and ideas. Patient: “Do you think I should tell the doctor?” Nurse: “Do you think you should?” 13. Focusing – concentrating on single point “This point seems worth looking at more closely.” 14. Exploring – delving further into a subject or idea “Tell me more about that..” “Would you describe it more fully?” 15. 15. Giving Information- making available the facts that the patient needs. “My name is….” “Visiting hours are…” 16. 16. “Seeking Clarification” – seeking to make clear that which is not meaningful or that which is vague; trying to clear up confusion about events or people. “I’m not sure that I follow.’ “What would you say is the main point of what you said?” 17. 17. Presenting Reality – offering for consideration that which is real; giving a realistic explanation of what the client says or hears. “I see no one else in the room” “ Your mother is not here, I’m a nurse” 18. Voicing Doubt – expressing uncertainty as to the reality of the patients perception; gently questioning the reality of the clients perception. “Isn’t that unusual?” “Really?” 19. Seeking Consensual Validation – searching for mutual understanding for accord in the meaning of the words; two or more people achieving agreement of interpretation of an event, behavior or issue. “Tell me whether my understanding of it agrees with yours..” 20. Verbalizing the Implied – voicing what the patient has hinted at or suggested. Patient: “ I can’t talk to you or to anyone. It’s a waste of time.” Nurse : “Is it your feeling that no understand you?” 21. Encouraging Evaluation – asking the patient to appraise the quality of his experience. “ What are your feelings in regard to” 22. Attempting to translate into feelingsfeelingsseeking to verbalize the feelings that are being expressed only indirectly. Patient: “I’m dead” Nurse: Are suggesting that you feel lifeless? Or is it that life seems without meaning?” 23. Suggesting Collaboration – offering to share, to strive, to work together with the patient for his benefit.

“Perhaps you and I can discuss and discover what produces your anxiety” 24. Summarizing – organizing and summing up that which has gone before. “Have I got this straight?” “You’ve said that..” 25. Encouraging Formulation of Plan of Action- asking the patient to consider kinds of behavior likely to be appropriate in further situations; planning appropriate resolution of a problem in graded steps.