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Therapeutic Communication The Helping Interview. Helping Relationship Characteristics Caring Caring Hopeful Hopeful Sensitive Sensitive Genuine Genuine.

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Presentation on theme: "Therapeutic Communication The Helping Interview. Helping Relationship Characteristics Caring Caring Hopeful Hopeful Sensitive Sensitive Genuine Genuine."— Presentation transcript:

1 Therapeutic Communication The Helping Interview

2 Helping Relationship Characteristics Caring Caring Hopeful Hopeful Sensitive Sensitive Genuine Genuine Empathy Empathy Positive Regard Positive Regard Values Self & Others Values Self & Others Empowering Empowering Teaching Teaching Goal- Oriented, Purposeful Goal- Oriented, Purposeful Time Limited Time Limited Assertive Assertive

3 Helping vs Social Relationships HELPING HELPING Care Care Trust Trust Growth Growth Purposeful/Intentional Purposeful/Intentional Unequal Sharing Unequal Sharing Focus on Clients Needs Focus on Clients Needs Time Limited Time Limited SOCIAL SOCIAL Care Care Trust Trust Growth Growth Spontaneous Spontaneous Similar Sharing Similar Sharing Focus on Needs of Focus on Needs of Both Individuals Both Individuals Ongoing Ongoing

4 Control GIVING HELP GIVING HELP feeling important feeling important feeling useful feeling useful feeling powerful feeling powerful feeling gratified feeling gratified feeling happy feeling happy NEEDING HELP NEEDING HELP feeling unimportant or inadequate feeling unimportant or inadequate feeling useless or depressed feeling useless or depressed feeling powerless feeling powerless feeling frightened or embarrassed feeling frightened or embarrassed feeling sad or angry feeling sad or angry

5 Phases of Helping Relationship Orientation (professional and client Orientation (professional and client to each other) to each other) Working (identification of the Working (identification of the clients problem) clients problem) Termination (resolution of the Termination (resolution of the clients problem) clients problem)

6 Orientation Phase getting to know you phase getting to know you phase sets the tone sets the tone introductions introductions roles roles initiated by the nurse initiated by the nurse agreement/contract/goals agreement/contract/goals trust develops trust develops

7 TRUST T try expression T try expression R reflection R reflection U use of silence U use of silence S setting limits S setting limits T time with client T time with client

8 Working Phase problem solving phase problem solving phase attend to clients needs attend to clients needs role of teacher/counselor role of teacher/counselor client actively participates client actively participates gather further data gather further data facilitate change facilitate change evaluate problems & goals evaluate problems & goals

9 Termination ending phase ending phase review and summarize progress & goals met/not met review and summarize progress & goals met/not met acknowledge feelings acknowledge feelings use clear language use clear language check the receiver understands check the receiver understands the message sent the message sent

10 Resolution clients mostly seeking explanation clients mostly seeking explanation how will problem affect their lives? how will problem affect their lives? what will need to be changed? what will need to be changed? how will they cope? how will they cope?

11 Avoid arguing arguing minimizing minimizing challenging challenging giving false reassurance giving false reassurance interpreting or speculating on the dynamics of the interpreting or speculating on the dynamics of the clients problems clients problems selling client on accepting treatment selling client on accepting treatment probing sensitive areas probing sensitive areas participating in criticism of any participating in criticism of any staff member staff member joining any attacks led by client joining any attacks led by client

12 Nursing Interventions to Encourage The Helping Relationship active listening active listening therapeutic communication techniques therapeutic communication techniques other factors other factors

13 attentive listening scale hard to maintain eye contact hard to maintain eye contact respond before other finishes speaking respond before other finishes speaking finish other peoples sentences finish other peoples sentences talk on and on so no one can respond talk on and on so no one can respond go on working while someone is talking to you go on working while someone is talking to you repeat a point just made repeat a point just made allow your mind to wander during a conversation allow your mind to wander during a conversation

14 good listening STOP TALKING STOP TALKING put the speaker at ease put the speaker at ease show that you want to listen show that you want to listen remove distractions remove distractions empathetic empathetic be patient be patient hold your temper hold your temper go easy on argument and criticism go easy on argument and criticism STOP TALKING STOP TALKING

15 communication techniques open ended questions (closed for obtaining specific information) open ended questions (closed for obtaining specific information) validating/clarifying validating/clarifying reflective/restating & paraphrasing reflective/restating & paraphrasing sequencing sequencing sharing observations sharing observations acknowledging feelings acknowledging feelings

16 interpersonal skills warmth and friendliness warmth and friendliness openness (acceptance) openness (acceptance) consideration of client variables consideration of client variables –non-english speaking –developmental considerations –older adults –sociocultural –occupational –patients with special needs

17 other factors promoting therapeutic communication comfortable environment comfortable environment Providing some personal space Providing some personal space privacy privacy confidentiality confidentiality client focus client focus optimal pacing optimal pacing nursing observations nursing observations

18 blocks to communication failure to respect client failure to respect client failure to listen failure to listen minimizing feelings minimizing feelings inappropriate comments & questions inappropriate comments & questions excessive questions excessive questions yes/no questions yes/no questions why & how why & how probing probing changing the subject changing the subject leading questions leading questions advice advice judgmental judgmental false reassurance false reassurance giving approval/disapproval giving approval/disapproval

19 therapeutic vs non-therapeutic THERAPEUTIC THERAPEUTIC facilitates transformation of working nurse/patient relationship facilitates transformation of working nurse/patient relationship relationship allows for adequate & accurate assessment & relationship allows for adequate & accurate assessment & data collection data collection performed with patient, not for patient performed with patient, not for patient NON-THERAPEUTIC NON-THERAPEUTIC hinders relationship formation hinders relationship formation prevents patient from becoming mutual partner & relegates him/her to passive recipient of care prevents patient from becoming mutual partner & relegates him/her to passive recipient of care

20 disclosure, yes or no? use self disclosure to help clients open up to you – not to meet your own needs use self disclosure to help clients open up to you – not to meet your own needs keep your disclosures keep your disclosures very brief very brief dont imply that your experience is exactly the same as dont imply that your experience is exactly the same as the clients the clients only self-disclose about situations that only self-disclose about situations that you have mastered you have mastered monitor your own comfort with monitor your own comfort with self-disclosure self-disclosure respect your clients needs for privacy respect your clients needs for privacy remember that there are cultural variations in the amount of self- disclosure considered appropriate remember that there are cultural variations in the amount of self- disclosure considered appropriate identify risks and benefits of identify risks and benefits of self disclosure self disclosure discuss the goals of the use of therapeutic self-disclosure discuss the goals of the use of therapeutic self-disclosure

21 medical care is not enough! We need more than medical We need more than medical care or surgery--we need care or surgery--we need competent care & competent care & a good communicator a good communicator


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