aspect of life.

‣ “Interpersonal techniques” have been identified to facilitate the nurse’s interaction in the process of helping the
client solve problems and make decisions concerning these difficulties.
◦A teacher is one who identifies learning needs and provides information to the client or family that may aid in
improvement of the life situation.
◦A leader is one who directs the nurse-client inter- action and ensures that appropriate actions are undertaken to
facilitate achievement of the designated goals.
◦A technical expert is one who understands vari- ous professional devices and possesses the clini- cal skills necessary
to perform the interventions that are in the best interest of the client.
◦A surrogate is one who serves as a substitute figure for another.

Phases of the nurse-client relationship are stages of overlapping roles or functions in relation to health problems, during
which the nurse and client learn to work cooperatively to resolve difficulties.
Peplau identified four phases:

■ Orientation is the phase during which the client, nurse, and family work together to recognize, clarify, and define the existing
problem.

■ Identification:
• is the phase after which the client’s initial impression has been clarified and when he or she begins to respond selectively to
those who seem to offer the help that is needed.
• “the patient recognizes the health care needs for which the nurse can provide assistance.” (Jones et al., 2020)
◦Clients may respond in one of three ways:
(1) on the basis of participation or interdependent relations with the nurse,
(2) on the basis of independence or isolation from the nurse
(3) on the basis of helplessness or dependence on the nurse (Peplau, 1991).

■ Exploitation is the phase during which the client proceeds to take full advantage of the services offered to him or her.
Having learned which serv- ices are available, feeling comfortable within the setting, and serving as an active participant in his
or her own health care, the client exploits the services available and explores all possibilities of the changing situation.

■ Resolution occurs when the client is freed from identification with helping persons and gathers strength to assume
independence.

Peplau’s Stages of Personality Development

• Psychological tasks are developmental lessons that must be learned on the way to achieving maturity of the personality.
Peplau (1991) identified four psychological tasks that she associated with the stages of infancy and childhood described by
Freud and Sullivan. She stated:
“When psychological tasks are successfully learned at each era of development, biological capacities are used productively
and relations with people lead to produc- tive living. When they are not successfully learned they carry over into adulthood and
attempts at learning continue in devious ways, more or less impeded by conventional adaptations that provide a
superstructure over the baseline of actual learning. (p. 166)”

• In the context of nursing, Peplau (1991) related these four psychological tasks to the demands made on nurses in their
relations with clients. She maintained that:

“Nursing can function as a maturing force in society. Since illness is an event that is experienced along with feelings that
derive from older experiences but are reenacted in the relationship of nurse to patient, the nurse-patient relationship is seen as
an opportunity for nurses to help patients to complete the unfin- ished psychological tasks of childhood in some degree. (p.
159)”