THERAPEUTIC

COMMUNICATION
 Communication

❖complex process
❖combination of verbal
and nonverbal behaviors
used in various ways to
share information.
 FACTORS THAT
INFLUENCE
COMMUNICATION
• Environment
• Relationship between
two people
• Context or content of the
message
 FACTORS THAT
INFLUENCE
COMMUNICATION
• Attitude
• Knowledge differences
• Perception
 Modes of
Communication

• Written Communication
• Verbal Communication
• Nonverbal Communication
– more revealing and truthful
than verbal communication.
 Therapeutic
Communication
• an interpersonal
interaction between the
nurse and the client during
which the nurse focuses on
the client’s specific needs to
promote an effective
exchange of information.
 Purposes 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.
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.
Active Listening and
Observation

• Active listening means refraining

from other internal mental
activities and concentrating
exclusively on what the client
says.
• Active observation means
watching the speaker’s
nonverbal actions as he or she
communicates.
• Empathy - the ability to
place oneself into the
experience of another
for a moment in time.
 “ I can understand
how difficult that must “ I understand
be for you. Tell me how you feel.
how you are feeling My father also
now and how you died that way
have been coping with and it really
the loss.” made me sad
for a year
afterward.”
Active Listening and
Observation
Help the nurse:
• Recognize the issue that is most important
to the client at this time
• Know what further questions to ask the
client
• Use additional therapeutic communication
techniques to guide the client to describe
his or her perceptions fully
• Understand the client’s perceptions of the
issue instead of jumping to conclusions
• Interpret and respond to the message
objectively
Verbal Communication
Skills
Using Concrete Messages
- the words are explicit and
need no interpretation; the
speaker uses nouns instead of
pronouns
Concrete Questions
- Clear, direct and easy to
understand
- Elicit more accurate response
Verbal Communication
Skills
Abstract messages
- Unclear patterns of words
that often contain figures of
speech that are difficult to
interpret
- require the listener to
interpret what the speaker is
asking.
 USING
THERAPEUTIC
COMMUNICATION
TECHNIQUES
 Avoiding
Nontherapeutic
Communication
 Interpreting
Signals or Cues
 Nonverbal
Communication Skills
 Nonverbal
Communication
Skills
–Facial expressions
(expressive, impassive or
confusing
–Body postures
–Hand gestures
–Vocal cues
–Eye contact
–Silence
 Nonverbal
Communication

•Proxemics*
–Intimate zone (0-18 “)
–Personal zone (18-36”)
–Social zone (4-12 ft)
–Public zone (12-25 ft)
•Touch
•Appearance
 Nonverbal
Communication
•Touch
1. Functional-professional
2. Social-polite touch
3. Friendship-warmth touch
4. Love-intimacy touch
5. Sexual-arousal touch
Special communication
techniques
Considerations:
▪ Touch will only
communicate warmth if the
nurse is comfortable with it
▪ Touch carries a different
meaning for each person
▪ Severable variables
influencing the intended
message of the touch
Special communication
techniques
Considerations:
• abused client – may pull
away and feel frightened
• For the paranoid –
confrontation
The End