THERAPEUTIC COMMUNICATION TECHNIQUESTHERAPEUTIC COMMUNICATION TECHNIQUES

1. 1. Using silenceUsing silence –– utilizing absence of communication utilizing absence of communication2.2. AcceptingAccepting – giving indication of reception; indicating that the – giving indication of reception; indicating that the nurse has hear and is willing to hear what the client says.nurse has hear and is willing to hear what the client says.

“Yes”“Yes”“Uh hmm”“Uh hmm”“I follow what you said”“I follow what you said”

3. 3. Giving recognitionGiving recognition – acknowledging indicating awareness. – acknowledging indicating awareness.“Good morning, Mr S.”“Good morning, Mr S.”“ I notice that you combed your hair”“ I notice that you combed your hair”

4. 4. Offering selfOffering self – making oneself available; introducing self and – making oneself available; introducing self and identifying relationship.identifying relationship.

“I’ll sit with you awhile”“I’ll sit with you awhile”I’ll stay here with you”I’ll stay here with you”

5. 5. Giving Broad OpeningsGiving Broad Openings- allowing the patient to take the - allowing the patient to take the initiative in introducing the topic; using open-ended questions initiative in introducing the topic; using open-ended questions that provide opportunity for the client to introduce topic.that provide opportunity for the client to introduce topic.

“Is there something you would like to talk about?”“Is there something you would like to talk about?”“What are you thinking about?”“What are you thinking about?”“Where would you like to begin?”“Where would you like to begin?”

6. 6. Offering General LeadsOffering General Leads…giving encouragement to continue.…giving encouragement to continue.“Go on.”“Go on.”“And then?”“And then?”

“Tell me about it.”“Tell me about it.”7. 7. Placing the Event in Time or in SequencePlacing the Event in Time or in Sequence…clarifying the …clarifying the relationship of events in time.; assessing time frame and relationship of events in time.; assessing time frame and sequence of an event over time.sequence of an event over time.

“Was this before or after…?”“Was this before or after…?”“When did this happen?”“When did this happen?”

8. 8. Making ObservationsMaking Observations…verbalizing what is perceived; …verbalizing what is perceived; verbalizing what nurses sees in client’s appearance and verbalizing what nurses sees in client’s appearance and behaviorsbehaviors

“You appear tense.”“You appear tense.”“I notice that you’re biting your lips.”“I notice that you’re biting your lips.”“It makes me uncomfortable when you…“It makes me uncomfortable when you…

9. 9. Encouraging Description of PerceptionsEncouraging Description of Perceptions – asking the patient – asking the patient to verbalize what he perceives; having the client describe to verbalize what he perceives; having the client describe his/her view of an event or experience.his/her view of an event or experience.

“Tell me when you feel anxious”“Tell me when you feel anxious”“What is happening”“What is happening”“ What does the voice seem to be saying”“ What does the voice seem to be saying”

10. 10. Encouraging ComparisonEncouraging Comparison – asking that similarities and – asking that similarities and differences be noted.differences be noted.

“Was this something like…?“Was this something like…? “Have you had similar experience?” “Have you had similar experience?”

1111. Restating. Restating – repeating the main idea expressed. – repeating the main idea expressed.Patient: “I cant sleep. I stay awake all night”Patient: “I cant sleep. I stay awake all night”Nurse: “You have difficulty sleeping?”Nurse: “You have difficulty sleeping?”

1212. Reflecting. Reflecting – directing back to the patient questions, feelings – directing back to the patient questions, feelings and ideas.and ideas.

Patient: “Do you think I should tell the doctor?”Patient: “Do you think I should tell the doctor?”Nurse: “Do you think you should?”Nurse: “Do you think you should?”

13. 13. Focusing Focusing – concentrating on single point– concentrating on single point“This point seems worth looking at more closely.”“This point seems worth looking at more closely.”

14. 14. Exploring Exploring – delving further into a subject or idea– delving further into a subject or idea“Tell me more about that..”“Tell me more about that..”“Would you describe it more fully?”“Would you describe it more fully?”

1515. Giving Information- . Giving Information- making available the facts that the making available the facts that the patient needs.patient needs.

“My name is….”“My name is….”“Visiting hours are…”“Visiting hours are…”

1616. “Seeking Clarification”. “Seeking Clarification” – seeking to make clear that which is – seeking to make clear that which is not meaningful or that which is vague; trying to clear up not meaningful or that which is vague; trying to clear up confusion about confusion about events or people.events or people.

“I’m not sure that I follow.’“I’m not sure that I follow.’“What would you say is the main point of what you “What would you say is the main point of what you

said?”said?”1717. Presenting Reality. Presenting Reality – offering for consideration that which is – offering for consideration that which is real; giving a realistic explanation of what the client says or real; giving a realistic explanation of what the client says or hears.hears.

“I see no one else in the room”“I see no one else in the room”“ Your mother is not here, I’m a nurse”“ Your mother is not here, I’m a nurse”

18. 18. Voicing DoubtVoicing Doubt – expressing uncertainty as to the reality of – expressing uncertainty as to the reality of the patients perception; gently questioning the reality of the the patients perception; gently questioning the reality of the clients perception.clients perception.

“Isn’t that unusual?”“Isn’t that unusual?”“Really?” “Really?”

19. 19. Seeking Consensual ValidationSeeking Consensual Validation – searching for mutual – searching for mutual understanding for accord in the meaning of the words; two or understanding for accord in the meaning of the words; two or more people achieving more people achieving agreement of interpretation of an agreement of interpretation of an event, behavior or issue.event, behavior or issue.

“Tell me whether my understanding of it agrees with “Tell me whether my understanding of it agrees with yours..”yours..”20. 20. Verbalizing the ImpliedVerbalizing the Implied – voicing what the patient has – voicing what the patient has hinted at or hinted at or suggested.suggested.

Patient: “ I can’t talk to you or to anyone. It’s a waste Patient: “ I can’t talk to you or to anyone. It’s a waste of time.”of time.”

Nurse : “Is it your feeling that no understand you?”Nurse : “Is it your feeling that no understand you?”21. 21. Encouraging EvaluationEncouraging Evaluation – asking the patient to appraise the – asking the patient to appraise the quality of his experience.quality of his experience.

“ What are your feelings in regard to”“ What are your feelings in regard to”22. 22. Attempting to translate into feelingsAttempting to translate into feelings- seeking to verbalize - seeking to verbalize the feelings that are being expressed only indirectly.the feelings that are being expressed only indirectly.

Patient: “I’m dead”Patient: “I’m dead”Nurse: Are suggesting that you feel lifeless? Or is it Nurse: Are suggesting that you feel lifeless? Or is it

that life seems without meaning?”that life seems without meaning?”23. 23. Suggesting CollaborationSuggesting Collaboration – offering to share, to strive, to – offering to share, to strive, to work together with the patient for his benefit.work together with the patient for his benefit.

“Perhaps you and I can discuss and discover what “Perhaps you and I can discuss and discover what produces your anxiety”produces your anxiety”24. 24. Summarizing –Summarizing – organizing and summing up that which has organizing and summing up that which has gone before.gone before.

“Have I got this straight?”“Have I got this straight?”“You’ve said that..”“You’ve said that..”

25. 25. Encouraging Formulation of Plan of Action-Encouraging Formulation of Plan of Action- asking the asking the patient to consider kinds of behavior likely to be appropriate in patient to consider kinds of behavior likely to be appropriate in further situations; further situations; planning appropriate resolution of a planning appropriate resolution of a problem in graded steps.problem in graded steps.