Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Mental Health
Chapter 9 - Therapeutic Communication
| Term | Definition |
|---|---|
| Therapeutic Technique: Silence | Gives the person time to collect thoughts or think through a point. Example: Encouraging a person to talk by waiting for the answers. |
| Therapeutic Technique: Accepting | Indicates that the person has been understood. An accepting statement does not necessarily indicate agreement but is nonjudgmental. Example: “Yes.” “Uh-huh.” “I follow what you say. |
| Therapeutic Technique: Giving recognition | Indicates awareness of change and personal efforts. Does not imply good or bad, right or wrong. Example: “Good morning, Mr. James.” “You’ve combed your hair today.” “I see you’ve eaten your whole lunch.” |
| Therapeutic Technique: Offering self | Offers presence, interest, and a desire to understand. Is not offered to get the person to talk or behave in a specific way. Example: “I would like to spend time with you.” “I’ll stay here and sit with you awhile.” |
| Therapeutic Technique: Offering general leads | Allows the other person to take direction in the discussion. Indicates that the nurse is interested in what comes next. Example: “Go on.” “And then?” “Tell me about it.” |
| Therapeutic Technique: Giving broad openings | Clarifies that the lead is to be taken by the patient. However, the nurse discourages pleasantries and small talk. Example: “Where would you like to begin?” “What are you thinking about?” “What would you like to discuss?” |
| Therapeutic Technique: Placing the events in time or sequence | Puts events and actions in better perspective. Notes cause-and-effect relationships and identifies patterns of interpersonal difficulties. Example: “What happened before?” “When did this happen?” |
| Therapeutic Technique: Making observations | Calls attention to the person’s behavior (e.g., trembling, nail-biting, restless mannerisms). Encourages patient to notice the behavior and describe thoughts and feelings for mutual understanding. Helpful with mute and withdrawn people. Example: “You appear tense.” “I notice you’re biting your lips.” “You seem nervous whenever John enters the room.” |
| Therapeutic Technique: Encouraging description of perception | Increases the nurse’s understanding of the patient’s perceptions. Talking about feelings and difficulties can lessen the need to act them out inappropriately. Example: “What do these voices seem to be saying?” “What is happening now?” “Tell me when you feel anxious.” |
| Therapeutic Technique: Encouraging comparison | Brings out recurring themes in experiences or interpersonal relationships. Helps the person clarify similarities and differences. Example: “Has this ever happened before?” “Is this how you felt …?”… “Was it something like…?”… |
| Therapeutic Technique: Restating | Repeats the main idea expressed. Gives the patient an idea of what has been communicated. If the message has been misunderstood, the patient can clarify it. Example: Patient: “I can’t sleep. I stay awake all night.” Nurse: “You have difficulty sleeping?” or Patient: “I don’t know… he always has some excuse for not coming over or keeping our appointments.” Nurse: “You think he no longer wants to see you?” |
| Therapeutic Technique: Reflecting | Directs questions, feelings, and ideas back to the patient. Encourages the patient to accept personal ideas and feelings. Acknowledges the patient’s right to have opinions and make decisions and encourages the patient to think of oneself as a capable person. Example: Patient: “What should I do about my husband’s affair?” Nurse: “What do you think you should do?” or Patient: “My brother spends all of my money and then has the nerve to ask for more.” Nurse: “You feel angry when this happens?” |
| Therapeutic Technique: Focusing | Concentrates attention on a single point. It is especially useful when the patient jumps from topic to topic. If a person is experiencing a severe or panic level of anxiety, the nurse should not persist until the anxiety lessens. Example: “This point you are making about leaving school seems worth looking at more closely.” “You’ve mentioned many things. Let’s go back to your thinking of ’ending it all.’” |
| Therapeutic Technique: Exploring | Examines certain ideas, experiences, or relationships more fully. If the patient chooses not to elaborate by answering no, the nurse does not probe or pry. In such a case, the nurse respects the patient’s wishes. Example: “Tell me more about that.” “Would you describe it more fully?” “Could you talk about how it was that you learned your mom was dying of cancer?” |
| Therapeutic Technique: Giving information | Makes facts the person needs available. Supplies knowledge from which decisions can be made or conclusions drawn. For example, the patient needs to know the role of the nurse, the purpose of the nurse-patient relationship, and the time, place, and duration of the meetings. Example: “My purpose for being here is…”… “This medication is for…”… “The test will determine…”… |
| Therapeutic Technique: Seeking clarification | Helps patients clarify their own thoughts and maximize mutual understanding between nurse and patient. Example: “I am not sure I follow you.” “What would you say is the main point of what you just said?” “Give an example of a time you thought everyone hated you.” |
| Therapeutic Technique: Presenting reality | Indicates what is real. The nurse does not argue or try to convince the patient, just describes personal perceptions or facts in the situation. Example: “That was Dr. Todd, not a man from the Mafia.” “That was the sound of a car backfiring.” “Your mother is not here; I am a nurse.” |
| Therapeutic Technique: Voicing doubt | Expressing uncertainty regarding the reality of the patient’s perceptions or conclusions, especially in hallucinations and delusions. Example: “Isn’t that unusual?” “Really?” “That’s hard to believe.” |
| Therapeutic Technique: Seeking consensual validation | Clarifies that both the nurse and patient share mutual understanding of communications. Helps the patient to clarify thoughts. Example: “Tell me whether my understanding agrees with yours.” |
| Therapeutic Technique: Verbalizing the implied | Puts into concrete terms what the patient implies, making the patient’s communication more explicit. Example: Patient: “I can’t talk to you or anyone else. It’s a waste of time.” Nurse: “Do you feel that no one understands?” |
| Therapeutic Technique: Encouraging evaluation | Aids the patient in considering other persons and events from the perspective of the patient’s own set of values. Example: “How do you feel about…?” “What did it mean to you when he said he couldn’t stay?” |
| Therapeutic Technique: Attempting to translate into feelings | Responds to the feelings expressed, not just the content. Often termed decoding. Example: Patient: “I am dead inside.” Nurse: “Are you saying that you feel lifeless? Does life seem meaningless to you?” |
| Therapeutic Technique: Suggesting collaboration | Emphasizes working with the patient, not doing things for the patient. Encourages the view that change is possible through collaboration. Example: “Perhaps you and I can discover what produces your anxiety.” “Perhaps by working together, we can come up with some ideas that might improve your communication with your spouse.” |
| Therapeutic Technique: Summarizing | Brings together important points of discussion to enhance understanding. Also allows the opportunity to clarify communications so that both nurse and patient leave the interview with the same ideas in mind. Example: “Have I got this straight?” “You said that…” “During the past hour, you and I have discussed…” |
| Therapeutic Technique: Encouraging formulation of a plan of action | Allows the patient to identify alternative actions for interpersonal situations the patient finds disturbing (e.g., when anger or anxiety is provoked). Example: “What could you do to let anger out harmlessly?” “The next time this comes up, what might you do to handle it?” “What are some other ways you can approach your boss?” |
| Nontherapeutic Communication: Giving premature advice | Assumes the nurse knows best and the patient can’t think for oneself. Inhibits problem solving and fosters dependency. Example: “Get out of this situation immediately.” More Helpful Response: Encouraging problem solving: “What are the pros and cons of your situation?” “What were some of the actions you thought you might take?” “What are some of the ways you have thought of to meet your goals?” |
| Nontherapeutic Communication: Minimizing feelings | Indicates that the nurse is unable to understand or empathize with the patient. Here the patient’s feelings or experiences are being belittled, which can cause the patient to feel small or insignificant. Example: Patient: “I wish I were dead.” Nurse: “Everyone gets down in the dumps.” “I know what you mean.” “You should feel happy you’re getting better.” “Things get worse before they get better.” Empathizing and exploring: “You must be feeling very upset. Are you thinking of hurting yourself?” |
| Nontherapeutic Communication: Falsely reassuring | Underrates a person’s feelings and belittles a person’s concerns. May cause the patient to stop sharing feelings if not taken seriously. Example: “I wouldn’t worry about that.” “Everything will be all right.” “You will do just fine, you’ll see.” Clarifying the patient’s message: “What specifically are you worried about?” “What do you think could go wrong?” “What are you concerned might happen?” |
| Nontherapeutic Communication: Making value judgments | Prevents problem solving. Can make the patient feel guilty, angry, misunderstood, not supported, or anxious to leave. Example: “How come you still smoke when your wife has lung cancer?” Making observations: “I notice you are still smoking even though your wife has lung cancer. Is this a problem?” |
| Nontherapeutic Communication: Asking “why” questions | Implies criticism; often has the effect of making the patient feel defensive. Example: “Why did you stop taking your medication?” Asking open-ended questions; giving a broad opening: “Tell me some of the reasons that led up to your not taking your medications.” |
| Nontherapeutic Communication: Asking excessive questions | Results in the patient not knowing which question to answer and possibly being confused about what is being asked. Example: Nurse: “How’s your appetite? Are you losing weight? Are you eating enough?” Patient: “No.” Clarifying: “Tell me about your eating habits since you’ve been depressed.” |
| Nontherapeutic Communication: Giving approval, agreeing | Implies the patient is doing the right thing—and that not doing it is wrong. May lead the patient to focus on pleasing the nurse or clinician; denies the patient the opportunity to change her mind. Example: “I’m proud of you for applying for that job.” “I agree with your decision.” Making observations: “I noticed that you applied for that job.” “What factors will lead up to your changing your mind?” Asking open-ended questions; giving a broad opening: “What led to that decision?” |
| Nontherapeutic Communication: Disapproving, disagreeing | Can make a person defensive. Example: “You really should have shown up for the medication group.” “I disagree with that.” Exploring: “What was going through your mind when you decided not to come to your medication group?” “That’s one point of view. How did you arrive at that conclusion?” |
| Nontherapeutic Communication: Changing the subject | May invalidate the patient’s feelings and needs. Can leave the patient feeling alienated and isolated and increase feelings of hopelessness. Example: Patient: “I’d like to die.” Nurse: “Did you go to Alcoholics Anonymous like we discussed?” Validating and exploring: Patient: “I’d like to die.” Nurse: “This sounds serious. Have you thought of harming yourself?” |
| Proxemics | The study of personal space In general, when working with patients you will want to maintain a distance that is equal to personal or social distance. Although patients are not friends or colleagues, you are engaging in a personal conversation with them. Four feet, which is the low end of social distance, is quite far away for a nurse-patient interaction. |
| Intimate distance | 0 to 18 inches in the United States is up to 18 inches and is reserved for those we trust most and with whom we feel most safe. |
| Personal distance | 18 inches to 4 feet - (18 inches to 4 feet) is for personal communications such as those with friends or colleagues. |
| Social distance | 4 to 12 feet - applies to strangers or acquaintances, often in public places or formal social gatherings. |
| Public distance | 12 feet or more - elates to public space (e.g., public speaking). In public space, one may hail another, and the parties may move about while communicating |
Created by:
bonitasoul
Popular Nursing sets