Therapeutic Communication

Objectives By the end of the lecture, students should be to: Define therapeutic communication Differentiate between verbal and non-verbal communication Discuss the components of communication Explain effective communication skills List the barriers to effective communication

Communication Complex process of sending, receiving and comprehending messages between two or more people Dynamic and on-going process Creates a unique experience between the participants Skill that can be learned

Uses of Communication Demonstrate care Establish relationships Obtain information Assist with changing behaviour NB: Therapeutic communication is foundational to the nurse-client relationship

Basic Communication Levels Intrapersonal –occurs within an individual Self talk- Internal discussion that takes place when an individual is thinking but nor verbalizing it Access client and or situation and critically think about it before verbalizing

Basic Levels CONT’D Interpersonal – occurs between two people Most common in nursing Requires exchange of information with an individual or small group of people

Basic Levels CONT’D Public – occurs with large groups of people Educational programmes Teaching in community settings

Basic Levels CONT’D Transpersonal- addresses spiritual needs Provides interventions to meet the needs

Basic Levels CONT’D Small group - within a group of people

Functional Components of Communication Referent -incentive or motive for communication Sender - Person who initiates the message Channel - method of transmitting and receiving the message (sight, hearing, touch) Receiver - person to whom message is aimed at

Functional CONT’D Environment- emotional and physical climate in which the communication took place Feedback- message returned to sender - Maybe verbal or non-verbal - Positive or negative NB: Feedback is an essential component of ongoing communication

Functional CONT’D Interpersonal variable- influence the communication between sender and receiver

Factors that Affect Verbal Communication Vocabulary- words Denotative/connotative meaning- share meaning Clarity/brevity- short and simple Timing/relevance- knowing when to communicate Pacing- rate of speech Intonation- tone of voice

Non-Verbal Communication - Assess the client’s non-verbal communication and meaning. - Attention to these are important Appearance Posture Gait Facial Expression Eye contact

Non-Verbal CONT’D Gestures Sounds Territoriality Personal space Silence

Therapeutic Communication Purposeful use of communication to build and maintain relationships with clients Elicit and attend to client’s thoughts, feelings, concerns and needs Express empathy and genuine concern for client and family Obtain information and give feedback about clients condition

Therapeutic CONT’D Intervene to promote functional bahaviour and effective interpersonal relationships Evaluates clients progress towards desired goals and outcomes NB: 1. Children and older adults requires altered techniques 2. T. Comm. is required in the nursing process

X’tics of Therapeutic Communication Client –centered - (not social or reciprocal) Purposeful Planned Goal directed

Essential Components of Therapeutic communication Time Attending bahaviour or active listening - Eye contact - Body language - Vocal quality - Verbal tracking Caring attitude Honesty Trust Empathy Non-judgemental attitude

Children Use simple, straight forward language Be aware of non-verbal messages Be at child’s eye level Incorporate play

Older Adults Client may require amplification Minimize distraction and face the client when speaking Allow plenty of time for the client to respond When communication is impaired, ask for input from caregivers

Effective Communication Skills Silence- allows time for meaningful reflection Active listening- hear ,observe and understand Open-ended questions- allow clients to explore feelings Clarifying techniques- use to check if information is accurate: Restating, reflecting, paraphrasing, exploring

Skills CONT’D General leads- start and continue talking Acceptance and recognition —interest and no judgment Focusing -conc. on what is important Asking questions - seek additional info. Giving info - provides details –decision making

Skills CONT’D Presenting reality - actual happening Summarizing - important points summary Offering self - relevant self disclosure Touch - communicate caring and comfort

Barriers to Effective Communication Asking irrelevant questions Offering personal opinions Giving advice Giving false assurances Minimizing feelings

Barriers CONT’D Changing the topic Asking ‘why’ questions Offering value judgment Excessive questioning Responding approvingly or disapprovingly