Mental Health Therapeutic Communication

Front 1

What are the phases of the therapeutic relationship?

Back 1

Pre-orientation
Orientation
Working
Termination

Front 2

Which phase of the therapeutic relationship consists of small talk before intro?

Back 2

Pre-orientation phase

Front 3

Which phase of the therapeutic relationship sets the scene for what's going to happen?

Back 3

Orientation phase

Front 4

What is discussed during the orientation phase?

Back 4

Parameters of the relationship
Contract
Confidentiality
Termination Begins

Front 5

Which phase of the therapeutic relationship involves that actual work; explores pt feelings?

Back 5

Working phase

Front 6

Which phase of the therapeutic relationship summarizes goals and ends relationship?

Back 6

Termination phase

Front 7

Thoughts and feelings that a patient has toward the nurse/psychiatrist that are rooted in the pt's unconscious/repressed emotions/feelings toward people in his/her past?

Back 7

Transference

Front 8

Thoughts and feelings that a health provider has toward the patient that may be related to the pt's unconscious/repressed emotions/feelings toward people in his/her past?

Back 8

Countertransference

Front 9

PROXEMICS

0-18 in. between people
usually comfortable between parents and child

Back 9

Intimate zone

Front 10

PROXEMICS

18-36 in. between people
distance between family/friends talking

Back 10

Personal zone

Front 11

PROXEMICS

4-12 ft between people
distance for communication in social/work/business setting

Back 11

Social Zone

Front 12

PROXEMICS

12-25 ft between people
distance between speaker and audience/small groups

Back 12

Public Zone

Front 13

Functional-Professional Touch

Back 13

Used in examinations or procedures

Front 14

Social-Polite Touch

Back 14

used in greeting, handshake, or when guiding someone

Front 15

Friendship-Warmth Touch

Back 15

Involves a hug or touch in shoulder

Front 16

Love-Intimacy

Back 16

tight hugs and kissing

Front 17

Tells the person what he should think, feel, or do. Implies that the person incapable of making decisions for him/herself. May result in a "Yes, but" interaction between both parties

Back 17

Giving Advice

Front 18

Tells the pt what he should think, feel, or do
ex.: "You need to..." "You should..."

Back 18

Giving advice

Instead: "Have you considered..."

Front 19

COMMUNICATION TECHNIQUES

Sanctions the person's ideas or behavior which implies the opposite is "bad"
ex.: "I'm happy to see that you're feeling more cheerful and positive today"

Back 19

Giving approval

Instead: "You seem more cheerful today, tell me about it"

Front 20

Indicates there is not cause for anxiety. Devalues the patients feelings.
ex.: "I wouldn't worry about that problem. It'll work itself out in time."

Back 20

Reassuring

Front 21

Opposes the pts ideas and implies the s/he is wrong.
ex.: "Your plan won't work"

Back 21

Disapproving

Front 22

Asks the pt to provide reasons for thoughts, feelings, behavior and events
ex.: "Why do you feel this way?"
"How could act in such an inappropriate way?"

Back 22

Requesting and explanation

Instead: "Help me understand what went into you acting in that way."

Front 23

Minimizes the impact of feelings. Conveys that the person's feelings are not serious, unique or important.
ex.: :I know jut how you feel"
"Everyone feels that way."

Back 23

Belittling the person's feelings

Front 24

Implies that the pt has no right to express his feelings or opinions
ex.: I always listen to you. Why would you say such a thing?"
"This hospital is very well equipped to handle your health care needs"

Back 24

Defending

Front 25

(Often Abruptly) directs the conversation where the nurse wants it to go
ex.: Pt. "I'm so tired of feeling this way."
Nurse "Let's talk about something more positive like how you're responding to the medication"

Back 25

Changing the subject

Instead.: "You sound very defeated and tired of feeling as you do. It must be frustrating. Let's take a moment to discuss the gains you've made since beginning the new medication"

Front 26

Demands an explanation or questions the pt's motives
ex.: "What makes you think you'll do anything different this time?"

Back 26

Challenging or Testing

Instead: "What are your thoughts about how you'll do this differently?"

Front 27

Impose your perceptions on another
ex.: "You have unresolved issues with your father that you're continuing to act out with your abusive husband."

Back 27

Interpreting

Instead: "How do you understand that you're living with an abusive man and that you were raised be one, too?"

Front 28

Allows the pt to take initiative in introducing the topic
ex.: "How are things going"
"What would you like to talk about today?"

Back 28

Giving broad opening

Front 29

Indicated interest and encourages the pt to continue talking
ex.: "Go on"
"Oh"
"Then what happened"

Back 29

Offering general leads

Front 30

Encourages the pt to consider what s/he just said
ex.: pt "I'm really scared about what just happened"
nurse "You're really scared?"

Back 30

Reflecting

Front 31

States observation of the pts behavior. Encourages pt to describe his/her experience.
ex.: "You're trembling"
"You seem upset"

Back 31

Sharing observation/perceptions

Front 32

Attempts to voice the feelings that are being addressed, only indirectly
ex.: "Sounds like you're being really demoralized about that encounter"

Back 32

Attempting to translate into feelings

Front 33

Encourages verbal communication, permits time for thought and conveys respect

Back 33

Silence

Front 34

Provides facts/information the pt may benefit from.
ex.: "If you wish to leave before your doctor discharges you, you'll need to sign a 72 hr release."

Back 34

Giving information

Front 35

Voices what the pt has hinted or suggested.
ex.: pt "It's a waste of time for me to attend activities on the unit."
nurse "You don't feel like these activities are helpful?"

Back 35

Verbalizing the implied

Front 36

Seeks to make clear that which is not understandable.
ex.: "I'm not sure I understand how you think that not taking your medicine ultimately benefits you?"

Back 36

Clarifying

Front 37

Attempt to clarify the relationship of events in chronological order and to time
ex: "Was this before or after?"
When did this happen?"

Back 37

Placing the event in time or sequence

Front 38

Organizes and sums up what has been discussed

Back 38

Summarizing

Front 39

Concentrates on a single point or issue
ex: "Let's talk about how you really feel about having to take medication."

Back 39

Focusing

Front 40

Expresses uncertainty as to the reality of the pt's perception
ex: "Well, I'm not sure that i understand that..."
"That's a very uncommon occurrence but tell me more..."

Back 40

Voicing doubt

Front 41

Delves further and deeper into a particular subject or idea
ex: "Tell me more about your experience at the clinic"

Back 41

Exploring

Front 42

Repeats the main idea communicated and prevents misunderstandings

Back 42

Restating

Front 43

The unconscious exclusion of a painful thought, feeling, memory or impulse from awareness?

Back 43

repression

Front 44

Conscious, deliberate forcing of unpleasant,anxiety-producing experiences from consciousness

Back 44

suppression

Front 45

An attempt to explain and/or justify one's idea, actions and feelings into a plausible, believable light. May sound like excuses; form of self-deception.

Back 45

rationalization

Front 46

Discharge of pent up feelings onto something or someone else in the environment that is less threatening than the original source of the feelnig

Back 46

displacement

Front 47

Separation and detachment of emotional significance and affect from an idea or situation

ex: Rape victim describes her rape experience with a bland, flat affect.

Back 47

dissociation

Front 48

Painful or anxiety producing experiences or realities are blocked from consciousness.

ex: Man reacts to son's death "No, this couldn't be so. The Dr. said he was fine."

Back 48

Denial

Front 49

Unconscious substitution of constructive and socially acceptable activity for unacceptable strong impulses. These impulses are often sexual or aggressive in nature.

ex: Hostility is displayed in sports or debate"
"A women with strong sexual impulse becomes a sculptor."

Back 49

Sublimation

Front 50

Attributing one's own unacceptable motives or characteristics to another person, group, objects or situations. Often sounds like blaming.

ex: Man is attracted to other women and blames wife of being flirtatious.

Back 50

Projection

Front 51

Returning to a previous level of adaptation

ex: A stressed adolescent curls up in bed with a teddy bear and wants to be nurtured by his mother

Back 51

Regression

Front 52

Unacceptable desires are kept from awareness by adopting the opposite behaviors in an exaggerated way.

ex: An individual shows extreme concern for someone he does not like

Back 52

reaction formation

Front 53

Overuse of abstract thinking, excessive details or generalization to control or minimize painful feelings.

ex: A man facing a divorce engages in a lengthy and lofty disclosure about divorce statistics and without mentioning feelings.

Back 53

Intellectulization

Front 54

Atonement for or attempt to dissipate unacceptable acts or wishes.

ex: A women has an affair and then buys her husband an expensive watch.

Back 54

Undoing

Front 55

Incorporation of the image of an emulated person, then acting, thinking and feeling like that person (unconscious mental mimicry)

ex: Gang members dress like their leader and steal like the leader does.

Back 55

Identidication

Front 56

Counterbalances for deficiencies in one area be excelling in another.

ex: Man fails in sports but studies hard and excels academically

Back 56

Compensation

Front 57

Deal with emotional conflicts or stressors by focusing on amusing aspects or ironic aspects with humor

Back 57

Humor

Front 58

Results in a polarized image of self/others as either all good or all bad

ex: Patient tells Nurse A she is the best, prettiest, etc and tells Nurse B she's the worst, meanest, etc

Back 58

Splitting

Front 59

Devotion of self to serving others as a way to manage stressors; gratifying but not self-sacrificing.

ex: Nuns/priests serve others for unselfish reasons

Back 59

Altruism

Front 60

Transforming anxiety on an unconscious level to a physical symptom that has no organic cause

ex: A doctoral student develops laryngitis on the day he is scheduled to defend his dissertation

Back 60

Somatization