1. Therapeutic Communication

2. 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

3. 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

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

5. 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

6. 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

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

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

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

10. 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

11. 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

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

13. 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

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

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

16. 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

17. 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

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

19. 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

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

21. 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

22. 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

23. 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

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

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

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