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Therapeutic Comm

Mental health

Communication An interactive process of transmitting information between two or more entities
Interpersonal communication A transaction between the sender and the reciever.
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 The closest distance that individuals will allow between themselves and others
Personal distance Approx 18-40 inches and reserved for interactions that are personal in nature, such as close conversations with friends or colleagues.
Social distance about 4-12 ft away from the body. Interactions at this distance include conversations with strangers or acquaintances, such as at a cocktail party or in a public building.
Public distance One that exceeds 12 ft. Speaking in public or yelling to someone some distance away.
Nonverbal communication Physical apperance and dress, body movement and posture, touch, facial expressions, eye behavior, and vocal cues or paralanguage.
Paralanguage The gestural component of the spoken word. Consists of pitch, tone, and loudness of spoken messages; the rate of speaking; expressively placed pauses; and emphasis assigned to certain words.
Using silence Therapeutic technique. Gives the client the opportunity to collect and organize thoughts, to think through a point, or to consider introducing a topic of greater concern than the one being discussed.
Accepting Therapeutic technique. Conveys an attitude of reception and regard. Ex: "Yes I understand what you said"
Giveing recognition Therapeutic technique. Acknowledge and indicating awareness; better than complimenting, which reflects the nurse's judgement. Ex:"Hello Mr. Jones I notice that you made your bed"
Offering self Therapeutic technique. Making oneself avaliable on an unconditional basis, increasing client's feelings of self-worth. Ex:"I'll stay with you awhile."
Giving broad openings Therapeutic technique. Allows the client to take the initative in introducing the topic; emphasizes the importance of the client's role in the interaction. Ex:"Tell me what you are thinking?"
Offering general leads Therapeutic. Offers the client encouragement to continue. Ex:"Yes, I see. Go on"
Placing the even in time or sequence Therapeutic. Clarifies the relationship of events in time so that the nurse and client can view them in perspective. Ex:"And what seemed to lead up to that?" "When did this happen?"
Making observations Verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and compare perceptions with the nurse. Ex:"You seem tense" "I notice you are pacing alot"
Encouraging description of perceptions Therapeutic. Asking the client to verbalize what is being perceived; often used with clients experiencing hallucinations. Ex:"Tell me what is happening now" "Are you hearing voices again?"
Encouraging comparision Therapeutic. Asking the client to compare similarities and differences in ideas, experiences, or interpersonal relationships. Ex:"How does this compare with the time when..?"
Restating Therapeutic. The main idea of what the client has said is repeated. Ex:Cl "I can't study. My mind keeps wandering." Ns "You have difficulty concentrating?"
Reflecting Questions and feelings are referred back to the client so that they may be recognized and accepted, and so that the client may recognize that his or her point of view has value. A good technique to use when the client asks the nurse for advice.
Focusing Taking notice of a single idea or even a single word; works esp well with a client who is moving rapidly from one thought to another. Ex:"This point seems worth looking at more closely. Perhaps you and I can dicuss it together."
Exploring Delving further into a subject, idea, experience, or relationship; esp helpful with clients who tend to remain on a superficial level of communication. Ex:"Please explain that situation in more detail"
Seeking clarification and validation Therapeutic. Striving to explain that which is vague or incomprehensible and searching for mutual understanding. Ex:"I'm not sure that I understand. Would you please explain?"
Presenting reality Therapeutic. When the client has a misperception of the environment, the nurse defines reality or indicates his or her perception of the situation. Ex:"I understand that voices seem real to you, but I do not hear them."
Voicing doubt Therapeutic. Experssing uncertaity as to the reality of the client's perceptions; often used with clients experiencing delusional thinking. Ex:"I find that hard to believe"
Verbalizing the implied Therapeutic. Putting into words what the client has only implied or said indirectly.
Attempting to translate words into feelings Therapeutic. When feelings are expressed indirectly, the nurse tries to "desymbolize" what has been said and to find clues to the underlying true feelings. Ex:Cl "I am way out in the ocean" Ns "You must be feeling very lonely"
Formulating a plan Therapeutic. When a client has a plan in mind for dealing with what is considered to be a stressful situation, it may serve to prevent anger or anxiety from escalating to an unmanageable level. Ex:"What could you do to let your anger out harmlessly?"
Probing Nontherapeutic. Peristent questioning of the client; pushing for answers to issues the client does not wish to discuss. Ex:"Tell me how your mother abused you when you were little."
Defending Nontherapeutic. Attempting to protect someone or something from verbal attack. Ex:"No one here would lie to you."
Requesting an explaination Nontherapeutic. Asking the client to provide the reasons for thoughts, feelings, behavior, and events. Asking "why". Ex:"Why do you think that?"
Indicating the existence of an external source of power Nontherapeutic. Attributing the source of thoughts, feelings, and behavior to others or to outside influences. Ex:"what makes you say that?" "What made you do that?"
Belittling feelings expressed Nontherapeutic. When the nurse misjudges the degree of the client's discomfort, a lack of empathy and understanding may be conveyed. Ex: cl"I have nothing to live for I wish I were dead." Ns"Everybody gets down in the dumps at times. I feel that way.."
Making sterotyped comments Nontherapeutic. Cliches and trite expressions are meaningless in a nurse-client relationship. Ex:"Im fine and how are you?" "Hang in there its for you own good"
Using denial Nontherapeutic. WHen the nurse denies that a problem exists, he or she blocks discussion with the client and avoids helping the client identify and explore areas of difficulty. Ex:Cl"Im nothing"Ns"Of course some something. Everybody is somebody."
Interpreting Nontherapeutic. With this technique the therapist seeks to make conscious that which is unconscious, to tell the client the meaning of his or her experience. Ex:"What you really mean is.."
Introducing an unrelated topic Nontherapeutic. Changing the subject causes the nurse to take over the direction of the discussion. Ex:Cl"I have nothing to live for" Ns"Did you have visitors this weekend?"
Created by: asau