the college of nurses of ontario presents the therapeutic nurse client relationship revised 2006 practice standard therapeutic communication and client-centered care four standard statements describe what a nurse is accountable for in the therapeutic nurse client relationship each statement has accompanying indicators which are broad statements that nurses can modify to their particular practice reality the standard statements are therapeutic communication client-centered care maintaining boundaries and protecting the client from abuse in this chapter you'll learn about therapeutic communication and client-centered care the standard statement for therapeutic communication states that nurses use a wide range of effective communication strategies and interpersonal skills to appropriately establish maintain re-establish and terminate the nurse client relationship now we'll review some of the indicators for therapeutic communication nurses achieve therapeutic communication by introducing themselves to clients by name and category giving clients an opportunity to express themselves without diminishing the client's feelings or immediately giving advice and telling clients about the role of the care team and that information will be shared with other members of the team nurses also achieve therapeutic communication by being aware of their verbal and non-verbal communication style and how clients may perceive it for example if you stand with your arms crossed while listening to a client the client may feel you are not interested it is also essential to use communication resources as necessary for example when language or literacy is hampering communication you may use a translator or provide an easy-to-read pamphlet in addition nurses achieve therapeutic communication by recognizing that all behavior has meaning they try to understand the cause of a client's unusual comment attitude or behavior for example the meaning behind a client refusing to eat may be that the client is fasting as part of a religious practice by exploring the client's refusal to eat you're respecting the client's beliefs and values and can integrate these into the plan of care throughout the relationship engage the client in discussions on how the client will meet care needs after the nurse client relationship ends for example you'll need to discuss discharge planning and arrange follow-up appointments or a referral to a community agency the standard statement for client centered care states that nurses work with the client to ensure that all professional behaviors and actions meet the therapeutic needs of the client now we'll review some of the indicators of client-centered care nurses achieve client-centered care by actively including the client and significant others as partners in the care identifying the client's goals wishes and preferences and making these the basis of the plan of care recognizing that the client's well-being is affected by the nurse's ability to establish and maintain a therapeutic relationship acknowledging that biases and feelings can affect the nurse client relationship and requesting to transfer care when the relationship is not evolving therapeutically you have now completed chapter three to work through another chapter in this module close this presentation and return to the learning center