SILLIMAN UNIVERSITY

COLLEGE OF NURSING
DUMAGUETE CITY
S.Y. 2021 - 2022

Resource Unit on Therapeutic Communication

Submitted To:
Asst. Prof. J-salf Salvacion Ablong

Prepared By:
Altaya, Trisha Mitch C.
Faburada, Jazzie Lace O.

Level III - D3
Topic title: Therapeutic Communication
Topic description: This topic focuses on Therapeutic Communication including its definition, things to consider for its effectivity, and its techniques.
Time allotment: 30 mins
Central objectives: By the end of the 30 mins discussion, the learners will be able to define what therapeutic communication is, learn about the
things to consider for an effective therapeutic communication, discuss the different types of techniques, and apply them when working with clients.

Specific Objectives Content T-L Activities T.A Evaluation Method

At the end of our 30 Lecture discussion Open forum with an

minute discussion, the with the use of interactive Q & A portion
learners will be able to: PowerPoint
presentation and ● Learners are
shared media (e.g. encouraged to ask
A. Definition videos, pictures) questions and clear up
shared screen via any confusion they
1. Define what ● What is Therapeutic communication? Google meet. may have.
therapeutic - According to Videbeck (2020), it is
communication is. an interpersonal interaction ● Learners will be
between the client and the nurse. 2 mins selected at random to
The nurse focuses on the client’s answer questions from
specific needs to promote an reporters with a 76
effective exchange of information. percent accuracy rate.
By using this type of
communication, the nurse is able to
understand and empathize with the
client’s experience.

B. Therapeutic communication & Nursing

2. Identify at least ● Therapeutic communication can help

(3-4) reasons why nurses accomplish many goals (Videbeck,
therapeutic 2020): 3 mins
communication is 1. Establish a therapeutic nurse–client
significant in the relationship.
 nursing practice. 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. This 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 the
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.

C. Privacy & Respecting Boundaries

3. Identify and ● As per Videbeck (2020), privacy is

differentiate the desirable but not always possible in
four (4) distance therapeutic communication. It is important 5 mins
zones involved in that the nurse evaluates whether interacting
communication. in the client’s room is therapeutic. For
instance, if the client is having difficulties
maintaining boundaries or is making
sexual comments, then the client’s room is
not the best setting. The nurse can talk
with the client at the end of the hall or in a
quiet corner of the day room or lobby,
depending on the physical layout of the
 setting.
● Proxemics is the study of distance zones
between people during communication.
McCall (2017) says that people feel more
comfortable with smaller distances if they
are communicating with someone they
know rather than with someone they don’t.
United States, Canada, and many Eastern
European nations generally observe four
distance zones (Videbeck, 2020):
1. Intimate (0 to 18 inches between
people): Comfortable for parents
with young children, people who
mutually desire personal contact, or
people whispering.
2. Personal (18 to 36 inches):
Comfortable between family and
friends who are talking.
3. Social (4 to 12 feet): Acceptable
for communication in social, work,
and business settings.
4. Public (12 to 25 feet): An
acceptable distance between a
speaker and an audience, small
groups, and other informal
functions (Hall, 1963).

D. Touch

4. Identify and ● Touching a client can be comforting and

describe the five therapeutic when permitted or is
(5) types of touch welcomed. When dealing with client’s, it’s
involved in important that the nurse observes for cues 5 mins
human that show whether touch is desired or
communication. indicated. As intimacy increases, the need
 for distance decreases (Videbeck, 2020).
Knapp (1980) had identified five types of
touch and this include the following:
1. Functional–professional touch
- One used in examinations
or procedures like when the
nurse touches a client
during physical assessment.
2. Social–polite touch
- One used in greeting
acquaintances such as doing
a handshake or “air kisses.”
3. Friendship–warmth touch
- Involves hugging, an arm
thrown over a friend’s
shoulder, or gently
backslapping to greet
friends or relatives.
4. Love–intimacy touch
- Involves tight hugs and
kisses between lovers or
close relatives.
5. Sexual–arousal touch
- Touch used by lovers

E. Active listening & observation

5. Describe what ● Active listening means concentrating

active listening exclusively on what the client says and
and observation is refraining from other internal activities. On
and its the other hand, active observation means 5 mins
importance. to watch for the client’s nonverbal actions
as he/she communicates.
● Active listening and observation help the
nurse (Videbeck, 2020):
 1. Recognize the issue that is most
important to the client at this time.
2. Know what further questions to ask
the client.
3. Use additional therapeutic
communication techniques to guide
the client to describe his or her
perceptions fully.
4. Understand the client’s perceptions
of the issue instead of jumping to
conclusions.
5. Interpret and respond to the
message objectively.

F. Using Therapeutic Communication

Techniques

6. Discuss at least ● Hays and Larson (1963) identified various

five (5) techniques that can help assist the nurse
therapeutic interact therapeutically with clients. The
techniques and following are a list of these techniques
provide an including some examples of each
example for each. (Townsend, 2008).
1. Using silence 10 mins
● Gives the client the
opportunity to collect and
organize thoughts, to think
through a point, or to
consider
introducing a topic of
greater concern than the one
being discussed.

2. Accepting
● Conveys an attitude of
 reception and regard. (Ex:
“Yes, I follow what you
said.” Eye contact;
nodding.)

3. Giving recognition
● Acknowledging and
indicating awareness; better
than complimenting, which
reflects the nurse’s
judgment. (Ex: “I notice
that you’ve combed your
hair.”)

4. Offering self
● Making oneself available on
an unconditional basis,
increasing client’s feelings
of self-worth. (Ex: “I’ll sit
with you awhile.”. “I’ll stay
here with you.”)

5. Giving broad openings

● Allows the client to take the
initiative in introducing the
topic; emphasizes the
importance of the client’s
role in the interaction. (Ex:
“What would you like to
talk about today?”)

6. Offering general leads

● Offers the client
encouragement to continue.
(Ex: “Yes, I see.” “Go
on.”)
7. Placing the event in time or
sequence
● Clarifies the relationship of
events in time so that the
nurse and client can view
them in perspective. (Ex:
“Was this before or
after…?” “When did this
happen?”)

8. Making observations
● Verbalizing what is
observed or perceived. This
encourages the client to
recognize specific
behaviors and compare
perceptions with the nurse.
(Ex: “You seem tense.” “I
notice you are pacing a
lot.”)

9. Encouraging description or
perceptions
● Asking the client to
verbalize what is being
perceived; often used with
clients experiencing
hallucinations. (Ex: “Tell
me what is happening
now.” “Are you hearing the
voices again?”)

10. Encouraging comparison

● Asking the client to
 compare similarities and
differences in ideas,
experiences, or
interpersonal relationships.
This helps the client
recognize life experiences
that tend to recur as well as
those aspects of life that are
changeable. (Ex: “Was this
something like…?” “How
does this compare with the
time when…?”)

11. Restating
● The main idea of what the
client has said is repeated;
lets the client know whether
or not an expressed
statement has been
understood and gives him
or her the chance to
continue, or to clarify if
necessary. (Ex: Cl: “I can’t
study. My mind keeps
wandering.”
Ns: “You have difficulty
concentrating.”)

12. Reflecting
● Questions and feelings are
referred back to the client
so that they may be
recognized and accepted,
and so that the client may
recognize that his or her
 point of view has value—a
good technique to use when
the client asks the nurse for
advice. (Ex: Cl: “What do
you think I should do about
my wife’s drinking
problem?”
Ns: “What do you think you
should do?”)

13. Focusing
● Taking notice of a single
idea or even a single word;
works especially well with
a client who is moving
rapidly from one thought to
another. This technique is
not therapeutic, however,
with the client who is very
anxious. Focusing should
not be pursued until the
anxiety level has subsided.
(Ex: “This point seems
worth looking at more
closely. Perhaps you and I
can discuss it together.”)

14. Exploring
● Delving further into a
subject, idea, experience, or
relationship; especially
helpful with clients who
tend to remain on a
superficial level of
communication. However,
if the client chooses not to
 disclose further
information, the nurse
should refrain from pushing
or probing in an area that
obviously creates
discomfort. (Ex: “Please
explain that situation in
more detail.”)

15. Seeking clarification and

validation
● Striving to explain that
which is vague or
incomprehensible and
searching for mutual
understanding. Clarifying
the meaning of what has
been said facilitates and
increases understanding for
both client and nurse. (Ex:
“I’m not sure that I
understand. Would you
please explain?”)

16. Presenting reality

● When the client has a
misperception of the
environment, the nurse
defines reality or indicates
his or her perception of the
situation for the client. (Ex:
“I understand that the
voices seem real to you, but
I do not hear any voices.”)

17. Voicing doubt

● Expressing uncertainty as to
 the reality of the client’s
perceptions; often used with
clients experiencing
delusional thinking. (Ex: “I
find that hard to believe.”
“That seems rather doubtful
to me.”)

18. Verbalizing the implied

● Putting into words what the
client has only implied or
said indirectly; it can also
be used with the client who
is mute or is otherwise
experiencing impaired
verbal communication. This
clarifies that which is
implicit rather than explicit.
(Ex: Cl: “It’s a waste of
time to be here. I can’t talk
to you or anyone.”
Ns: “Are you feeling that no
one understands?”)

19. Attempting to translate words

into feelings
● When feelings are
expressed indirectly, the
nurse tries to “desymbolize”
what has been said and to
find clues to the underlying
true feelings. (Ex: Cl: “I’m
way out in the ocean.”
Ns: “You must be feeling
very lonely now.”)
 20.Formulating a plan of action
● When a client has a plan in
mind for dealing with what
is considered to be a
stressful situation, it may
serve to prevent anger or
anxiety from escalating to
an unmanageable level.
(Ex: “What could you do to
let your anger out
harmlessly?”)

References:

Townsend, M.C. (2008). Psychiatric Mental Health Nursing Concepts of Care in Evidence-Based Practice. 6th Edition. Philadelphia: F.A Davis
Company.

Videbeck, S.L. (2020). Psychiatric-Mental health nursing. 8th Edition. Philadelphia: Wolters Kluwer