the surgery"). person.b. Reflective listening (e.g., "Are you saying you think your blood might all come out if you have an IV?").A reflective listener rephrases what was said forclarification.3. Provide opportunity for ventilation of feelings andacknowledge feelings expressed. If the child is unable toexpress feelings verbally, use play to encourage self-expression (see Skill, Therapeutic Play, Unit VIII).When the child ventilates feelings, he or she is able tocope more effectively. Young children especially havedifficulty expressing feelings and need an adult to helpname their feelings. A child learns it is acceptable tofeel/express emotions when an adult acknowledges thefeelings.4. Use silence when appropriate. A quiet presence can communicate caring and concern.A common misconception is that something needs to besaid to be therapeutic.5. Communicate as honestly and as accurately aspossible.a.
Give accurate information. Tell the child if theinformation is a guess.b.
Offer to get answers; locate information whennecessary.c.
Use terms the child understands; explainmedical terms when used.d.
Use visual aids, e.g., charts, drawings, ormodels to promote accuracy.Honest, accurate communication facilitates trust andestablishes safe parameters in which concerns andquestions can be aired.6. Observe for blocks to communication (see Box 6-2,Blocks to Communication, text p. 110).Blocks have an adverse effect on the communicationprocess.7. Allow time for questions, both at the time and later.Provide paper and pen or pencil.Absorbing information is a process. Additionalquestions may surface after the passage of time and theopportunity for reflection. With paper and pen or pencil,questions can be written down in order to remember toask them at a later time.8. Convey sincerity.a.
When choosing phrases of comfort or support.Phrases such as "I understand" are of no value unless theperson saying it has truly been in that situation.Furthermore, most situations are viewed as unique, andsuch a statement may provoke well-deserved anger.
the third person could be more effective, e.g., "Other children in your situationhave told me
they felt very helpless. Is that how you're feeling right now?
When sharing private information about self. Traditionally, personal disclosure was discouraged. Amore open approach is advocated today. However,relating private information should have a purpose.Validation of feelings through personal experience canprove very supportive to the child.9. Use humor when appropriate. Sharing humor invites those present to come a littlecloser. Humor provides a common ground to softencultural and economic barriers.10. Use a variety of communication methods (see Box 6-4, Creative Communication Techniques for Children,text pp. 115-116).Using a variety of communication techniques may elicita more effective response.
Evaluation Outcomes Observational Guidelines
1. Communication is effective. Techniques of therapeutic communication areemployed. The child communicates and interacts in acomfortable manner. Needed information is exchanged.Copyright © 2006 by Elsevier, Inc.