Communication - Therapeutic and Non- Therapeutic
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| Communication What are the four components ? | 1. Giving and receiving information
2. Involves a sender and a receiver
3. Is a learned process
4. Is verbal and non-verbal.
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| Factors influencing communication : * General attitude * Cultural * Environmental * Age/ developmental level * Distance | * General attitude- Can block out communication, may not hear what is being said. * Cultural - Possible language barier; customs. * Environment- Time and place * Age/development level- People think diffrently at different age levels
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| Distance - 1. Intimate - ? 2. Personal - ? 3. Social- ? 4. Public- ? | Intimate= 0 to 18 inches
Personal = 18 inches to 40 inches
Social = 4 to 12 feet
Public- more than 12 feet
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| What are the two types of communication ? | Verbal and Non-verbal communication .
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| What is verbal communication ? | The spoken word .
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| What is the non- verbal communication ? ( 65% -95% of communication ) | * Appearance / dress
* Body movement and posture
* Touch : social , friendship, love&intimacy, sexual,
* Facial expressions
* Eye behavior - Opens the communication ; more than 3 seconds-indicates strong emotions
Staring- Always inapproriate
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| Voice | Paralanguage -
* Pitch - sound ( high, normal , low )
* Tone - emotional component
* Loudness
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| Congruence | Face is expressing what words are saying.
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| Therapeutic Communication - Deals with problems and behaviors | * Demonstrates empathy (understanding)
* Requires Skills
* REsponds to patients thoughts , needs and concerns
* Builds trust
* Allows free expession of thoughts adn feelings
* Non- judgmental
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| Non- Therapeutic Communication - Interactions which causes patients to feel : | * Defensive
* Misunderstood
* Minimized
* Discouraged from expressing thoughts and feelings .
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| Listening | * Foundation for Therapeutic Communication
* Requires Concentration, skill, and active listening
*Remove distraction
* Prevent Interruptions or keep to a minimum
* Comfort * Note congruence * NOn- judgemental
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| SOLER | * S sit with patient (preferably at 90 degree angle)
* O - Open posture (no crossing of arms or legs)
* L - lean forward
* E - eye contact ( appropriate)
* R - relax :)
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| Assertivness ( Confident statements ) | * saying what one thinks, feels or wants in a direct , respectful way
* Adult communication
* Use "I" statements rather than "you" statements
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| Limit Setting | * Matter of fact- stay cool and calm , avoid using a lot of emotions
* Non- attacking
* Be firm without being demeaning or critical
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| Supportive Confrontation | * Point out, in a caring way, discrepancies in what patients say and do
* Use perception check
** describe behavior
** Offer at least two possible interpretations
** Ask for feedback
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| Self Disclosure | * Focus on the patient
* Don't talk about self unless asked a direct question
* Establish rapport ( relation, understanding)
* Small amount is therapeutic
* Helps to build trust
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| Offers support | * Keep disclosure brief
* Don't discuss your personal problems
*** Do not give out your phone number or address
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| Assertivness - The following is a simple formula for making an assertive statement based on adult-adult interaction, as opposed to talking down to clients ( parent- child communication) | Assertivnes is marked by the use of " I statements" as opposed to " you statements" that blame or atack other person
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| Assertivness | *I udnerstand /know/ can .. " ( show empathy ( understanding) acknowledge others view point )
* "But I think/feel.."( Express the conflict from a personal view or experience )
* " So I suggest / prefer/ would like ..." (Make a specific plan or proposa
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| Confrontation - By giving two alternatives, the nurse makes the messge tentative and gives the situation open for the client to provide feedback . | A perception check a form of confrontation has the adantage of not accusing the client or making assumptions about his or her behavior because the nurse offers at least two possible interpretations.
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| Special situations : Psychoses | Pateints with psychoses are out of touch with reality
* thinking is out of reach
* speech is disorganized
* Ns- Focus on reality , do not reinforce psychotic thinking, remain calm , give adequate interpersonal space
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| Special Situations : Patient with Anxiety | * Provide comfort and assure safety
* Give brief explanation
* Be directive ("Sit down.Take a deep breath and focus on what I am saying ")
* Be calm.
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