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MH Chap 8
Therapeutic Communication
| Question | Answer |
|---|---|
| Formulating Plan of Action | Striving to prevent anger or anxiety escalating to unmanageable levels when stressor recurs "Next time this comes up, wat might U do to handle it more appropriately" |
| Attempting to Translate Words into Feelings | Putting into words the feelings the clien has expressed only indrectly & to find clues to the underlying true feelings; CL- Im way out in the ocean RN U must be feeling very lonely now |
| Verbalizing the Implied | Put in words wat has is implied or said indirectly;Clarifies wat is implicit rather than explicit;Cl-Its a waste of time,I cant talk to U.RN-R U feeling no one understands. CL-mute.RN It must have been very difficult for U when ur hubby died in the fire |
| Voicing Doubt | Expressing uncertainty as to the reality of the clients perceptions; Often used with clients experiencing delusional thinking; "I find that hard to believe" |
| Presenting Reality | Clarifying misconceptions that may be expressed When pt. has misperception of enviroment, RN defines reality or indicates perception of situation "I understand the voices seem real to u, but I do not hear any voices" |
| Seeking Clarification & Validation (Clarifying) | Strivng to explain wat i vague & searching for mutual understanding; Clarifying wat has been said; "Do I understand that u said..." "Could U explain more ab that to me..." |
| Exploring | Delving further into a subject, idea, experience, or relationship; Helpful with clients who tend to remain on a superficial level of communication; "Tell me more about that particular situation" |
| Focusing | Taking notice of a single idea or even a single word; Works with clients who rapidly move from 1 thought to another: "This point seems worth looking at more closely, perhaps U & I can discuss it together" |
| Reflecting (about pt. feelings) | Directs ?'s or feelings back so that they may be recognized & accepted, & they may recognize their point of view haqs value: Use when client asks RN for advice Cl-My sis want help with mother, i do it all RN-U feel angry when she doesnt help |
| Restating (Repeat) | Lets a client know whether an expressed statement has or has not been understood; Cl-I cant study, my mind keeps wondering RN- U have difficulty concentrating |
| Encouraging Comparison | Client compares similaritiesw & differences in ideas, experiences, or relationships;Helps client recognize experiences that recur or that r changable "Wat was ur response last time this occured" |
| Encouraging Description of Perception | Asking client to verbalize wat is being perceived; Often used with clients experiencing hallucinations; "R U hearing the voices again" |
| Making Observations | Verbalizing what is observed or perceived; This encourages the client to recognize specific behaviors & compare perceptions with the RN; "I notice u r pacing alot" |
| Placing the Events in Time or Sequence | Clarifies the relationship of events in time so that the RN and client can view them in perspetive; "When did u first notice..." |
| Offering General Leads | Minimal encouragement; Encourages the client to continue; "Go on" "uh-huh" "and after that" |
| Broad Openings | Allows client to select topic; Emphasizes importance of the clients role in the interaction; "Tell me what u r thinking" |
| Offering Self | Making oneself available on an unconditional basis, increasing the clients feelings of self-worth; "I'll stay with u awhile." |
| Using Silence | Allows client to take control of discussion, if they so desire; Gives the client opportunity to collect or process thoughts; *Sitting quietly* |
| Giving Recognition | Acknowledgeing; indicating awareness; " I notice ur wearing a new dress." |
| Accepting | Belief/agree; conveys positive regard; "I can imagine how that might feel" |
| Giving Reassurance | Nontherapeutic; May discourage client from further expression of feelings if client believes the feelings will only be belittled |
| Rejecting | Nontherapeutic; Refusing to consider client’s ideas or behavior |
| Approving or Disapproving | Nontherapeutic; Implies that the nurse has the right to pass judgment on the “goodness” or “badness” of client’s behavior |
| Agreeing or disagreeing | Nontherapeutic; Implies that the nurse has the right to pass judgment on whether client’s ideas or opinions are “right” or “wrong” |
| Giving Advice | Nontherapeutic; Implies that the nurse knows what is best for client and that client is incapable of any self-direction |
| Probing | Nontherapeutic; Pushing for answers to issues the client does not wish to discuss causes client to feel used and valued only for what is shared with the nurse |
| Defending | Nontherapeutic; To defend what client has criticized implies that the client has no right to express ideas, opinions, or feelings |
| Requesting an Explanation | Nontherapeutic; Asking “why” implies that the client must defend his or her behavior or feelings |
| Indicating the existence of an External Source of Power | Nontherapeutic; Encourages the client to project blame for his or her thoughts or behaviors on others |
| Belittling Feelings Expressed | Nontherapeutic; Causes the client to feel insignificant or unimportant |
| Making Stereotyped Comments, Cliches, Trite expressions | Nontherapeutic; These are meaningless in a nurse-client relationship |
| Using Denial | Nontherapeutic; Blocks discussion with the client and avoids helping him or her identify and explore areas of difficulty |
| Interpreting | Nontherapeutic; Results in the therapist’s telling client the meaning of his or her experience |
| Introducing an Unrelated Topic | Nontherapeutic; Causes the nurse to take over the direction of the discussion |
| Territoriality | The innate tendency to own space |
| Density | The number of people within a given environmental space |
| Distance | The means by which various cultures use space to communicate |
| Intimate distance | 0-18 inches;The closest distance that individuals allow between themselves and others |
| Personal distance | 18-40 inches;The distance for interactions that are personal in nature, such as close conversation with friends |
| Social distance | 4-12 feet; The distance for conversation with strangers or acquaintances |
| Public distance | Exceed 12 Feet; The distance for speaking in public or yelling to someone some distance away |
| Active Listening S.O.L.E.R | S—Sit squarely facing the client. O—Observe an open posture. L—Lean forward toward the client. E—Establish eye contact. R—Relax. |
Created by:
mromerobr
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