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King Saud University

College of nursing

Psychiatric nursing department

Master program

Course title \ Clinical practical psychiatric patient

521 NurCourse number :

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At the end of this session the student will be to:

1. Discuss the process of communication.

2. Identify and explain the components of the communication process.

3. Compare and contrast the different levels of communication.

4. Explain the various modes of communication.

5- Identify the blocks to therapeutic communication.

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1-Introduction2-Definition

3-Communication process4-types of communication

5-Relationship between verbal and non verbal communication

6-Factors affecting communication7-Goals of therapeutic communication

8-Characteristic of successful communication 9-Blooks of communication

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Communication is an interpersonal process that involves verbal and nonverbal exchanges of information and ideas .

Communication refers not only to content but also to feelings and emotions that people

may convey in a relationship. Therapeutic communication is an ongoing

process of interactions through which client needs are identified .

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Sender

Receiver

Message Channel

Feed back

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The Communication CycleThe Communication Cycle

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Example communication process : The sender sends a message to

the receiver.

Communication takes place only if the receiver understands the sender’s message.

It requires the participation of both sender and receiver.

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Communication through words or language, Spoken and written language is comprised of verbal cues.

Often Para- verbal (or paralinguistic)

cues accompany verbal messages. These cues include pitch & tone of voice; speed, variation, & volume

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This is the behavior that accompanies the verbal content.

Non verbal communication is often more important than verbal communication.

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Non verbal communication conveys interest ,warmth support ,rapport ,approval, protection ,reassurance ,concern and encouragement

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Non verbal communication includes Paralanguage : tone of voice, stream of talk, kinesics body languages & facial movement. Proximity: this includes the distance between

the sender and the receiver

Touch: touch is an important mean of non verbal communication.

Social artifacts

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nonverbal "channels" of communication (how something is said) are often more important than words alone (what is said) .

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This couple are giving out signals that we can probably interpret with some confidence.

"Read" their facial expressions, observe their closeness and body positioning and "receive" some information. These people look happy, relaxed and comfortable in each others' company

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Even if someone decides to say nothing they are still communicating"  

Do you agree? Is this gentleman communicating anything?

Another well-known saying is...

"silence speaks louder than words"

So how is the information conveyed?

Answer: Through Body Language

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What about this picture ?Again there are strong "signals ,"

Comments about body language

1-It can be difficult to accurately assess what 'message' is being transmitted

2-It doesn't convey  precise, detailed information

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"....                                  

Eye contact with the other side is an essential part of Communication.

Without it the other party will feel remote from you and are unlikely to relate to you in a meaningful way. It is important to be aware of how sensitive people are to it. Eye contact should be a positive form of body language communication, but if it is not used correctly it can easily become negative.

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Communication skills effectives of verbal & non-verbal communication

• Active listening • Questioning • Use of simple language • Reflecting feelings • Paraphrasing • Silence

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• Listening skills • Pay full attention • Use facial expressions that show

interest and concern • Use eye contact • Use encouraging gestures such

as nodding head • Take posture, that reflects paying

of all attentive and respect

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Trust: The client’s belief that the nurse will behave predictably & competently while respecting the client’s needs

Honesty: The ability to be truthful, honest, & sincere

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Validation: Listening to the client and responding congruently in order to be sure that the nurse and client have the same understanding of a problem or issue

Caring: The level of emotional involvement

between the nurse and the client

Active listening: Hearing and interpreting language, noticing nonverbal and paraverbal enhancements, and identifying underlying feelings

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Techniques that allow the client to set the paceOffering self Nurse is available, physically & emotionally Indicates nurse’s willingness/intent to help Nurse’s presence is reassuring; may prompt client to continue Indicates nurse’s attention and interest

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Broad openings Encourages client to choose topic for

discussion demonstrates respect for client’s thoughts emphasizes importance of client’s needs

e.g. “What do you want to talk about?”

“Can you tell me more about that?”

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Silence Gives client time to reflect Encourages client to express self Indicates interest in what client has to

say Increases nurse’s understanding of client’s message

Helps to structure and pace the interaction or conversation lulls

Conveys respect and acceptance

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Techniques that encourage spontaneity

Open-ended comments

Unfinished sentences that prompt client to continue

Questions that cannot be answered with a one word answer

Allows client to decide what content is relevant

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*Reflect feelings by identifying and sending back a message acknowledging the feeling of another person or repeating the last few wards that the client said.

*Re- state or repeat the client statement as encouragement for the client’s to continue.

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*Ensure harmony of verbal and non verbal message

*Clarify

*Feedback

*Focus & re-focus

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1- Personality of both sender and receiver including strengths, weaknesses, skills, values, perception, background experience.

2-Environment in which communication occurs.

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Blocks of communicationBlocks of communication• Giving advice• Using medical terms• Changing the subject• Giving false reassurance• Value judgment• Being incongruent • Jumping to conclusion • Long periods of silence

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The return response of the listener

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• Establish a therapeutic provider-client relation

• Assess client’s perception of the problem

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The communication process is fundamental to any human relationship.The components of the communication process include sender, message, channel, receiver & feed back.There are several different levels in which persons communicate with one another, including intrapersonal, interpersonal, group, & interdisciplinary.Verbal and nonverbal messages are modes of communication that exist in the nurse-client relationship

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ReferencesReferences• [1] National Cancer Institute (NCI). Making Health Communications

Work. Pub. No. NIH 89-1493. Washington, DC: U.S. Department of Health and Human Services (HHS), 1989.

• [2] Piotrow, P.T.; Kincaid, D.L.; Rimon, II, J.G.; et al. Health Communication. Westport, CT: Praeger, 1997.

• [3] Jackson, L.D., and Duffy, B.K., eds. Health Communication Research. Westport, CT: Greenwood, 1998.

• [4] Science Panel on Interactive Communication and Health. Eng, T.R., and Gustafson, D.H., eds. Wired for Health and Well-Being: The Emergence of Interactive Health Communication. Washington, DC: HHS, 1999.

• [5] Northouse, L.L., and Northouse, P.G. Health Communication: Strategies for Health Professionals. 3rd ed. Stamford, CT: Appleton & Lange, 1998.

• [6] Maibach, E., and Parrott, R.L. Designing Health Messages. Thousand Oaks, CA: Sage Publications, 1995.

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CONTCONT..[7] Ray, E.B., and Donohew, L., eds. Communication and Health:

Systems and Applications. Hillsdale, NJ: Lawrence Erlbaum Associates, 1990.

[8] Freimuth, V.S.; Stein, J.A.; and Kean, T.J. Searching for Health Information: The Cancer Information Service Model. Philadelphia, PA: University of Pennsylvania Press, 1989.

[9] Atkin, C., and Wallack, L., eds. Mass Communication and Public Health. Newbury Park, CA: Sage Publications, 1990.

[10] Backer, T.E.; Rogers, E.M.; and Sopory, P. Designing Health Communication Campaigns: What Works? Newbury Park, CA: Sage Publications, 1992.

[11] Harris, L.M., ed. Health and the new media. Technologies Transforming Personal and Public Health. Mahwah, NJ: Lawrence Erlbaum Associates, 1995.

[12] Street, R.L.; Gold, W.R.; and Manning, T., eds. Health Promotion and Interactive Technology: Theoretical Applications and Future Directions. Mahwah, NJ: Lawrence Erlbaum Associates, 1997

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Thank you