Ati Rn 8.0 Therapeutic Communication Techniques

Front 1

Intrapersonal Communication

Back 1

Communication that occurs within an individual - "self-talk".

This occurs within one’s self and is the internal discussion that takes place when an individual is thinking thoughts and not outwardly verbalizing them.

In nursing, intrapersonal communication allows the nurse to assess a client and/or situation and critically think about the client/situation before communicating verbally.

Front 2

Interpersonal Communication

Back 2

Communication that occurs between two or more people in a small group.

This form of communication is the most common in nursing and requires an exchange of information with an individual or small group.

Front 3

Public Communication

Back 3

Communication that occurs within large groups of people.

In nursing, this commonly occurs during educational endeavors where the nurse is teaching a large group of individuals, such as in a community setting.

Front 4

Transpersonal Communication

Back 4

Communication that addresses an individual's spiritual needs and provides interventions to meet those needs.

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Vocabulary

Back 5

Words used to communicate either a written or spoken message impact on communication:
limited vocabulary or speaking a language other than English may make it difficult for the nurse to communicate with the client.

Use of medical jargon may decrease client understanding.

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Denotative/connotative meaning

Back 6

When communicating, participants must share meanings.

Words that have multiple meanings may cause miscommunication if they are interpreted differently.

Front 7

Clarity/brevity

Back 7

the shortest, simplest communication is usually most effective

Front 8

timing/relevance

Back 8

knowing when to communicate allows the receiver to be more attentive to the message

Front 9

Pacing

Back 9

The rate of speech can communicate a meaning to the receiver.

Speaking rapidly may communicate the impression that the nurse is in a rush and does not have time for the client.

Front 10

Intonation

Back 10

the tone of voice can communicate a variety of feelings.

The nurse can communicate feelings, such as acceptance, judgment, and dislike through tone of voice.

Front 11

Nonverbal Communication

Back 11

Nurses should be aware of how they communicate nonverbally.

The nurse should assess the client’s nonverbal communications for the meaning being conveyed, remembering that culture impacts interpretation. Attention to the following behaviors is important, as it is compared to the verbal message being conveyed:
* Appearance
* Posture
* Gait
* Facial expresions
* Eye contact
* Gestures
* Sounds
* Territoriality
* Personal space
* Silence

Front 12

Therapeutic Communication

Back 12

The purposeful use of communication to build and maintain helping relationships with clients, families, and significant others.

The nurse uses interactive, purposeful communication skills to:
* elicit and attend to the client’s thoughts, feelings, concerns, and needs
* express empathy and genuine concern for the client’s and family’s issues
* obtain information and give feedback about the client’s condition
* intervene to promote functional behavior and effective interpersonal relationships
* evaluate the client’s progress toward goals and outcomes.

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Characteristics of Therapeutic Communication

Back 13

Client centered – not social or reciprocal.

Purposeful, planned, and goal-directed.

Front 14

Time

Back 14

Plan for and allow adequate time to communicate.

Front 15

Attending Behaviors or Active Listening

Back 15

These are nonverbal means of conveying interest in another.

* Eye contact typically conveys interest and respect but varies by situation and culture.
* Body language and posture may demonstrate level of comfort and ease.
* Vocal quality enhances rapport and emphasizes particular topics or issues.
* Verbal tracking provides feedback by restating or summarizing a client’s statements.

Front 16

Caring Attitude

Back 16

Show concern and facilitate an emotional connection with the client and the client’s family.

Front 17

Honesty

Back 17

Be open, direct, truthful, and sincere.

Front 18

Trust

Back 18

Demonstrate reliability without doubt or question.

Front 19

Empathy

Back 19

Convey an objective awareness and understanding of the feelings, emotions, and behaviors of others, including trying to envision what it must be like to be in the position of the client and the client’s family.

Front 20

Nonjudgmental Attitude

Back 20

This is a display of acceptance that will encourage open, honest communication.

Front 21

Assessment

Back 21

Assess verbal and nonverbal communication needs.

Consider the client’s developmental level and how communication should be altered during the assessment phase.

Identify any cultural considerations that may impact communication.

Front 22

Assessment - Children

Back 22

Use simple, straightforward language.

Be aware of own nonverbal messages, as children are sensitive to nonverbal communication.

Enhance communication by being at the child’s eye level.

Incorporate play in interactions.

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Assessment - Older Adult

Back 23

Recognize that the client may require amplification.

Minimize distractions, and face the client when speaking.

Allow plenty of time for the client to respond.

When impaired communication is assessed, ask for input from caregivers or family to determine the extent of the deficits and how best to communicate.

Front 24

Planning

Back 24

Minimize distractions.

Provide for privacy.

Identify mutually agreed-upon client outcomes.

Set priorities according to the client’s needs.

Plan for adequate time for interventions.

Front 25

Implementation

Back 25

Establish a trusting nurse-client relationship.

The client feels more at ease during the implementation phase when a helping relationship has been established.

Provide empathetic responses and explanations to the client by using observations and providing hope, humor, and information.

Front 26

Silence

Back 26

silence allows time for meaningful reflection

Front 27

Active Listening

Back 27

the nurse is able to hear, observe, and understand what the client communicates and to provide feedback

Front 28

Open-ended Questions

Back 28

this technique facilitates spontaneous responses and interactive discussion

Front 29

Clarifying Techniques

Back 29

This technique is used to determine if the message received was accurate:
* Restating – uses the client’s exact words.

* Reflecting – directs the focus back to the client in order for the client to examine his feelings.

* Paraphrasing – restates the client’s feelings and thoughts for the client to confirm what has been communicated.

* Exploring – allows the nurse to gather more information regarding important topics mentioned by the client.

Front 30

offering general leads, broad opening statements

Back 30

this encourages the client to determine where the communication can start and to continue talking

Front 31

showing acceptance and recognition

Back 31

this technique acknowledges the nurse’s interest and nonjudgmental attitude

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Focusing

Back 32

this technique helps the client to concentrate on what is important

Front 33

asking questions

Back 33

asking questions is a way to seek additional information

Front 34

giving information

Back 34

this technique provides details that the client may need for decision making

Front 35

Presenting reality

Back 35

this technique is used to help the client focus on what is actually happening and to dispel delusions, hallucinations, or faulty beliefs

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Summarizing

Back 36

summarizing emphasizes important points and reviews what has been discussed

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Offering self

Back 37

Use of this technique demonstrates a willingness to spend time with the client.

Limited personal information may be shared, but the focus should return to the client as soon as possible.

Relevant self-disclosure by the nurse allows the client to see that his experience is shared by others and understood.

Front 38

Touch

Back 38

if appropriate, touch communicates caring and may provide comfort to the client

Front 39

Barriers to Effective Communication

Back 39

Asking irrelevant personal questions.
Offering personal opinions.
Giving advice.
Giving false reassurance.
Minimizing feelings.
Changing the topic.
Asking “why” questions.
Offering value judgments.
Excessive questioning.
Responding approvingly or disapprovingly.

Front 40

Client Outcomes

Back 40

The client will verbalize concerns to the nurse.

The client will request assistance from the nurse as appropriate.

The client will communicate needs to the nurse.