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Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 4 Therapeutic Communication Skills.

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Presentation on theme: "Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 4 Therapeutic Communication Skills."— Presentation transcript:

1 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 4 Therapeutic Communication Skills

2 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Importance of Communication Foundation for all patient care Therapeutic communication skills create feelings of comfort for patients

3 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Communication Cycle Involves two or more individuals exchanging information Involves sending and receiving messages

4 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Communication Cycle ^^ The communication cycle and channels of communication.

5 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Four Elements of the Communication Cycle The sender begins cycle by encoding message The message delivered via a channel or mode of communication Speaking Listening Gestures or body language Writing

6 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Four Elements of the Communication Cycle The receiver must decode the meaning of the message Feedback takes place after receiver has decoded message sent by sender

7 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Communication Cycle Listening skills –Active listening involves verifying message from sender –Received message is sent back to sender worded slightly differently

8 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Verbal Communication Takes place when message is spoken Sender and receiver must apply same meaning to spoken words

9 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Verbal Communication The five Cs of communication –Complete –Clear Eye contact enhances clarity Articulate and enunciate Time to process message Message must be heard –Concise –Cohesive –Courteous

10 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Verbal Communication Good communication skills help establish rapport with patients –Call patients by full name –Encourage patients to verbalize feelings –Give technical information to patients clearly Allow patients to make practical application to their health needs

11 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nonverbal Communication Body language –Unconscious body movements, gestures, and facial expressions Body language can communicate more than spoken words >>

12 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nonverbal Communication Body Language –Expressions that accompany speech –Kinesics is study of body language –Body language learned first –Body language influenced by primary caregivers and culture

13 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nonverbal Communication Feelings and emotions are communicated through nonverbal means –70% of language is nonverbal –Tone of voice communicates 23% of message –Spoken word communicates 7% of message

14 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nonverbal Communication Facial expression –Eyes reflect feelings –Staring is invasion of privacy –Cultural influences affect facial expressions Personal space –Comfortable personal space –Handled differently by various cultures –Explain procedures that will be invasive

15 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nonverbal Communication Posture –Relates to position of body or parts of body –Involves at least half the body Position –Face-to-face communication –Should enable observation of verbal and nonverbal cues

16 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nonverbal Communication Positive posture and position encourage therapeutic communication >>

17 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nonverbal Communication Gestures and mannerisms –“Talk” with hands –Enhances spoken word Touch –Appropriate touch is therapeutic –Not all patients are comfortable with touch

18 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Congruency in Communication Click to play the video

19 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Congruency in Communication Verbal and nonverbal messages must agree The meaning of mixed messages Clustering groups of nonverbal messages Masking conceals true feeling or message

20 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Congruency in Communication Perception –Conscious awareness of one’s own feelings and the feelings of others –Sense another’s attitudes, moods, and feelings –Follow perceived assessments with verbal validation –Easily misinterpreted

21 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Barriers to Therapeutic Communication Age and gender barriers Economic barriers Education and life experience barriers

22 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Barriers to Therapeutic Communication Bias and prejudice barriers Verbal roadblocks to therapeutic communication

23 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Defense Mechanisms as Barriers Regression Denial Repression Projection Sublimation Displacement Compensation Rationalization Undoing

24 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Barriers to Therapeutic Communication Barriers caused by cultural and religious diversity –Caregiving expectations –Time focus

25 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Barriers to Therapeutic Communication Human needs as barriers to communication Maslow’s hierarchy of needs >>

26 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Establishing Multicultural Communication The patient must trust the professional Steps to building trust include: –Risk/trust –Conveying empathy –Showing respect –Being genuine –Active listening

27 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Working with Multicultural and Diverse Patient Populations Click to play the video

28 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cultural Brokering Cultural broker serves as a go-between One who advocates on behalf of another individual or group within the health care community

29 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Cultural Brokering Goal of cultural brokering –Increase the capacity of health care and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems Cultural brokers may assume the role of medical interpreter

30 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Working with Interpreters Interpreters do not provide word-for-word equivalence, rather focus on the accurate expression of equivalent meaning Remember to speak directly to the patient, not to the interpreter

31 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Working with Interpreters A family member may serve as the interpreter Disadvantage of a family member serving as interpreter –They may not understand medical terminology –It would be very difficult for a family member to share a poor prognosis or a life-threatening diagnosis

32 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Interview Techniques Closed questions –“Are you taking your medications?” Open-ended questions –“How are you coming along with your diet?” Indirect statements –“Tell me what you’ve been doing since your retirement.”

33 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Point of Care Techniques Location where the patient and provider or patient and office personnel physically interact

34 Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Community Resources Need to refer patient to a community resource Developing a community resource document


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