THERAPEUTIC COMMUNICATION

Goals of Therapeutic Communication

1. Establish a therapeutic nurse-client relationship.
2. Identify the most important client concern at that moment (the client-centered goal)
3. Assess the client’s perception of the problem as it unfolds. Includes detailed actions
(behaviors and messages) of the people involved and the client’s thoughts and feelings
about the situation, others and self.
4. Facilitate the client’s expression of emotions.
5. Teach the client and family necessary self-care skills
6. Recognize the client’s needs.
7. Implement interventions designed to address the client’s needs.
8. Guide the client toward identifying a plan of action to a satisfying and socially acceptable
resolution.

Therapeutic Communication Techniques

1. Accepting
 Indicating reception
 “Yes.” / Nodding / “I follow what you said.”

2. Broad openings
 Allowing the client to take the initiative in introducing the topic
 “Is there something you like to talk about?”

3. Consensual validation
 Searching for mutual understanding for accordance in the meaning of the words
 “Tell me whether my understanding of it agrees to yours”

4. Encouraging comparison
 Asking that similarities and differences be noted
 “Was it something like?”

5. Encouraging description of perceptions

 Asking the client to verbalize what he or she perceives
 “Tell me when you feel anxious.” / “What is happening?”

6. Encouraging expression
 Asking the client to appraise the quality of his or her experiences
 “What are your feelings in regard to…..?”

7. Exploring
 Delving further into a subject or idea
 “Tell me more about it/that….”

8. Focusing
  Concentrating on a single point
 “Of all the concerns you’ve mentioned, which is most troublesome?”

9. Formulating a plan of action

 Asking the client to consider kinds of behaviors likely to be appropriate in future
situations
 “Next time this comes up, what might you do to handle it?”

10. General leads

 Giving encouragement to continue
 “Go on.” / “And then…” / “Tell me about it…”

11. Giving information

 Making available the facts that the client needs
 “My name is….” / “Visiting hours are….”
12. Giving recognition
 Acknowledging, indicating awareness
 “Good morning, Mr. ……” / “I noticed that you combed your hair….”

13. Making observations

 Verbalizing what the nurse perceives
 “You appear tense. “/ “Are you comfortable when….?”

14. Offering self

 Making oneself available
 “I’ll stay / sit here for a while.”

15. Placing event in time or sequence

 Clarifying the relationship of events in time
 “Was this before or after?”

16. Presenting reality

 Offering for consideration that which is REAL
 “I see no one here in the room.” / “I’m not your mother, I’m your nurse.”

17. Reflecting
 Directing client actions, thoughts and feelings back to the client (Rephasing)

18. Restating
 Repeating the main idea expressed

19. Seeking information

 Seeking to make clear that which is not meaningful or that is vague
 “Have I heard you correctly?”

20. Silence
  Absence of verbal communication, which provides time for the client to put thoughts
or feelings into words, to regain composure, or to continue talking
 Nurse should maintain eye contact.

21. Suggesting collaboration

 Offering to share, to strive, to work with the client for his or her benefit
 “Perhaps you and I can discuss and discover what triggers your anxiety.”

22. Summarizing
 Organizing and summing up that which has gone before
 “During the past hour, you and I discusses…” / “You’ve said that….. “

23. Translating into feelings

 Seeking to verbalize client’s feelings that he or she expresses only indirectly
 Patient: “I’m dead.”
Nurse: “Are you suggesting that you feel lifeless?”

24. Verbalizing the implied

 Voicing what the client has hinted at or suggested
 Patient: “I don’t want to talk. I’m a waste of time.”
Nurse: “Do you feel that no one understands?”

25. Voicing doubt

 Expressing uncertainty about the reality of client’s perceptions.
 “Really? Isn’t that unusual?”