1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 07Communication in Mental Health Nursing

2. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Communication Process of exchanging information –Person –Person receiving message –Message itself Verbal Nonverbal Nursing—centered on needs and problems of the client

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Speech Patterns: Blocking Loses train of thought—stops speaking because of unconscious block “Then my father…what was I saying?”

4. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Speech Patterns: Circumstantiality Describes in too much detail—cannot be selective When asked “Do you have any physical illness?” replies “My head hurts, but my nose has been leaking, my hair just won’t stay in place, I have this cramping in my joints…”

5. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Speech Patterns: Echolalia Repeats the last word heard over and over “Please wait here” is responded to with “here, here, here…”

6. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Speech Patterns: Loose Association Speaks constantly, shifting between loosely related topics “Martha married Jim who is a good cook. I can cook. Cows are something we can cook. I wonder why a cow moos?”

7. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Speech Patterns: Flight of Ideas Shifts rapidly between unrelated topics “My cat is gray. The food here is good. My hair needs a perm.” http://www.youtube.com/watch?v=9Hpz-9rwuqA

8. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Speech Patterns: Neologism Coins new words and definitions “Hiptomites are real powerful people” in reference to a husky mental health technician on the unit

9. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Speech Patterns: Verbigeration Repeats words, phrases, sentences several times Nurse: “It’s time to take your pill” Client: “Take your pill, take your pill, take your pill…”

10. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Therapeutic Communication Goal is to learn about the client and his or her problem Use verbal and nonverbal techniques Nurse–client relationship influenced by many factors Every message filtered by both the sender and the receiver

11. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Objectivity Ability to view facts and events without distortion by –Personal feelings –Prejudices –Judgments

12. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Verbal Communication Techniques Table 7.1 Pg 106

13. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Nonverbal Communication in Action Box 7.1 Pg 106 Intermittent eye contact Facial expression Arms and legs uncrossed Respecting personal space Use of touch Active listening

14. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Nontherapeutic Communication Messages and behavior that hinder the therapeutic process Closed body language Closed-ended questions Personal opinions or values Clichés Condescending attitude Criticism

15. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following speech patterns is demonstrated when a client repeats the last word heard? A. Echolalia B. Flight of ideas C. Neologism D. Verbigeration

16. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer A. Echolalia Rationale: A client exhibiting echolalia will verbally repeat the last word that he or she hears.

17. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following is NOT an example of therapeutic communication? A. Validation B. Using a general lead C. Using silence D. Closed-ended questions

18. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer D. Closed-ended questions Rationale: Closed-ended questions allow a “yes” or “no” response without encouraging further information from the client. These types of questions are a barrier to therapeutic communication.

19. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. Therapeutic communication includes both verbal and nonverbal techniques.

20. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Rationale: In the exchange of information between the nurse and the client, therapeutic communication will include both verbal and nonverbal techniques.

21. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins