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CHAPTER 6: Therapeutic Communication

Chapter 6: Therapeutic Communication

Key Terms:
o Abstract Messages: unclear patterns of words that often contain figures of speech that are difficult to
interpret
o Active Listening: concentrating exclusively on what the client says, refraining from other internal mental
activities
o Active Observation: watching the speakers nonverbal actions as he or she communicates
o Assertive Communication: ability to express positive and negative ideas and feelings in an open, honest,
and direct way
o Body Language: a nonverbal form of communication: gestures, postures, movements, and body positions
o Circumstantiality: the use of extraneous words and long, tedious descriptions
o Closed Body Positions: nonverbal behavior such as crossed legs and arms folded over chest that indicate
the listener may be failing to listen, may be defensive, or not accepting
o Communication: the process that people use to exchange information
o Concrete Messages: words that are clear as possible when speaking to the client so that the client can
understand the message; concrete messages are important for accurate information exchange
o Congruent Message: when communication content and processes agree
o Content: verbal communication; the literal words that a person speaks
o Context: the environment in which an event occurs; include the time and the physical, social, emotional,
and cultural environments
o Cues (Overt and Covert): verbal or nonverbal messages that signal key words or issues for the client
o Directive Role: asking direct, yes/no questions and using problem solving to help the client develop new
coping mechanism to deal with present, here-and-now issues
o Distance Zones: amount of physical space between people during communication; in the U.S, Canada,
and many Eastern European nations, four distance zones are generally observed: intimate zone, personal
zone, social zone, and public zone
o Eye Contact: looking into other persons eyes during communication
o Incongruent Messages: when the communication content and process disagree
o Intimate Zone: space of 0-18 inches between people; the amount of space comfortable for parents with
young children, people who mutually desire personal contact, or people whispering; invasion of this
intimate zone by anyone else is threatening and produces anxiety
o Nondirective Role: using broad openings and open-ended questions to collect information and help the
client identify and discuss the topic of concern
o Nonverbal Communication: the behavior that accompanies verbal content, such as body language, eye
contact, facial expression, tone of voice, speed and hesitations in speech, grunts and groans, and distance
from the listener
o Personal Zone: space of 18-36 inches; a comfortable distance between family and friends who are talking
o Process: in communication, denotes all nonverbal messages that the speaker uses to give meaning and
context to the message
o Proxemics: the study of distance zones between people during communication
o Public Zone: space of 12-25 feet; the acceptable distance between a speaker and an audience, between
small groups, and among others at informal functions
o Social Zone: a space of 4-12 feet, which is the distance acceptable for communication in social, work, and
business setting
o Spirituality: a clients beliefs about life, health, illness, death, and ones relationship to the universe;
involves the essence of a persons being and his or her beliefs about the meaning of life and the purpose
for living
o Therapeutic Communication: an interpersonal interaction between the nurse and the client during which
the nurse focuses on the clients specific needs to promote an effective exchange of information
o Verbal Communication: the words a person uses to speak to one or more listeners
Objectives:
UNIT 2: Building the Nurse-Client Relationship 1
CHAPTER 6: Therapeutic Communication
o Describe the goals of therapeutic communication
o Identify therapeutic and nontherapeutic verbal communication skills
o Discuss nonverbal communication skills such as facial expression, body language, vocal cues, eye
contact, and understanding of levels of meaning and context
o Discuss boundaries in therapeutic communication with respect to distance and use of touch
o Distinguish between concrete and abstract messages
o Given a hypothetical situation, select an effective therapeutic response to the client

UNIT 2: Building the Nurse-Client Relationship 2