Therapeutic Communication Chapter 4: Therapeutic Communication Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

Communication Most powerful tool in psychiatric nursing The method used to activate the nursing process Foundation of the nurse-patient relationship A dynamic process in which two or more people share information

Effective Communication Major factor in determining client: Satisfaction Treatment compliance Recovery Essential to outcome

Figure 4-1 Model of the communication process.

Factors that Influence Communication Environment Relationship between sender and receiver Content and context of message Attitude, values, beliefs Ethnic background and socioeconomic status Family dynamics, life experience Knowledge level Ability to relate to others

Three Purposes of Communication Facilitate self expression for the promotion of healthy growth Understand the significance of the patient’s problems To assist with the identification and resolution of the problems

Written Communication Primarily used to share information Nurse must be precise and succinct Organize ideas clearly, write legibly, proper grammar Document in objective, clear, and concise terms

Verbal Communication Spoken words May mean different things to different people Figures of speech, slang, jokes, clichés, colloquialisms

Cultural Considerations Develop sensitivity to cultural aspects of communication Examine cues from nonverbal responses

Nonverbal Communication Composes 93% of any communication Body language Paralinguistics Space Touch Appearance

Social Communication Everyday situations Family relationships, social activities, school Superficial, light, and usually does not have a goal

Principles of Therapeutic Communication Know self Understand what motivates one to help others Be in control of own life and emotions Perform periodic self-evaluation of responses to patient

Types of Communication Intrapersonal Interpersonal Social Collegial Therapeutic

Nursing Roles Role model Teacher Socializer Advocate Parent Counselor Therapist

Traits of Therapeutic Communication Genuineness Positive regard Empathy Trustworthiness Clarity Responsibility Assertiveness

Special Communication Techniques Self-disclosure Touch Humor

Obstacles to Therapeutic Communication Resistance Transference Countertransference Boundary violations

Responding Techniques That Enhance Therapeutic Communication Silence Active listening Support and reassurance Sharing observations Acknowledging feelings Broad, open-ended statements Information giving Interpretation

Responding Techniques That Enhance Therapeutic Communication, cont’d Restating Reflecting Clarifying Confronting Summarizing Role-playing

Challenges in Communication Legal status/rights Confidentiality Informed consent Brief stays Physical impairments Culture, language, and understanding Difficult patients Difficult coworkers