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

2. 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

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

4. Figure 4-1 Model of the communication process.

5. 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

6. 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

7. 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

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

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

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

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

12. 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

13. Types of Communication
Intrapersonal
Interpersonal
Social
Collegial
Therapeutic

14. Nursing Roles Role model Teacher Socializer Advocate Parent Counselor
Therapist

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

16. Special Communication Techniques
Self-disclosure
Touch
Humor

17. Obstacles to Therapeutic Communication
Resistance
Transference
Countertransference
Boundary violations

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

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

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