Therapeutic Communication in Nursing

Learning Objectives

• Define the concept and purpose of therapeutic communication.
• Provide examples of techniques that promote therapeutic communication.
• Identify barriers to effective communication.
• Distinguish between effective and ineffective communication techniques.

What is Therapeutic Communication?

• A method to establish a nurse-patient relationship.
• Involves compassion, empathy, and respect.
• Techniques include presence, listening, genuineness, and empathy.
• Practice through process recordings.

Nurse-Patient Relationship

• A mutual learning experience and developmental model.
• Benefits include:
  • Corrective emotional experience.
  • Promotes insight and behavior change.
  • Goals: self-realization, self-acceptance, improved personal relationships.

Achieving Therapeutic Goals

• Explore patient's life experiences.
• Encourage expression of thoughts and feelings.
• Relate behaviors to thoughts.
• Maximize ego strengths and encourage socialization.

Self-Awareness in Therapeutic Communication

• Know personal biases and perform self-awareness exercises.
• Reflect on personal values and ethics.
• Core values: human dignity, integrity, autonomy, altruism, social justice.

Therapeutic Milieu

• Containment: Ensure physical safety, provide structure.
• Support: Enhance self-esteem and comfort.
• Involvement: Encourage patient participation.
• Validation: Acknowledge feelings and promote expression.

Role of the Nurse

• Model adaptive and growth-producing behavior.
• Approach life with growth, hope, and adaptability.

Communication Techniques

• Verbal: spoken/written words.
• Non-verbal: body language, facial gestures.
• Must be congruent with verbal communication.

Key Communication Techniques

• Active listening, broad openings, reflection, validation.
• Avoid 'why' questions; use open-ended questions.
• Restate and clarify to ensure understanding.
• Recognize and address feelings behind hallucinations/delusions.

Phases of Nurse-Patient Relationship

1. Pre-interaction: Self-awareness and preparation.
2. Introduction: Establish trust and clarify roles.
3. Working: Explore stressors, promote insight and behavior change.
4. Termination: Prepare for end of the relationship and future interactions.

Addressing Conflict

• Understand personal responses to conflict.
• Manage anxiety and fear; use team support.
• Use congruent communication.

Effective vs. Ineffective Techniques

• Effective: Broad openings, active listening, reflection.
• Ineffective: Advising, agreeing, belittling, challenging.

Clinical Vignettes

• Illustrate practical applications of communication techniques.

Conclusion

• Therapeutic communication improves patient care and self-insight.
• Practice role-playing scenarios to evaluate and improve communication skills.

Further Information

• Contact Stephanie Arnold or Debbie Rhodes for more resources.