Therapeutic Communication

1
United Church of Christ in the Philippines

Widdoes St. Brgy. II, City of San Fernando, La Union
2500 Philippines
School of Health and Sciences
Therapeutic Communication
Skills Laboratory Activity
Baliba, Joseph Michael N.

BSN-3A
Bachelor of Science in Nursing
Union Christian College
City of San Fernando, La Union
Philippines
2023
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Objectives
In the nursing profession, therapeutic communication is essential, particularly for student
nurses. Its main goal is to help the patient and the nurse build a supportive relationship that
promotes empathy, understanding, and trust. These are some of the main goals:
Building Trust: It facilitates the development of a connection based on trust between the
patient and the nurse, which is necessary for providing care in an efficient manner.
Knowing Patient Needs: Nurses can gain a deeper understanding of patients' physical,
emotional, and psychological needs by using effective communication techniques. This
knowledge makes it possible to provide more efficient and individualized care.
Offering Emotional Support: Nurses can offer patients emotional support by using
therapeutic communication to help them deal with their emotions, anxieties, and worries. It
promotes free communication between patients and their thoughts, feelings, and worries, which
helps to clarify their
Improving Patient Compliance: When treatment plans, prescriptions, and procedures are
explained to patients in a clear and compassionate manner, their comprehension and compliance
are increased.
Empowering Patients: Nurses can enable patients to take an active role in their own care
and decision-making by using therapeutic communication.

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For us student nurses, developing therapeutic communication skills is crucial to providing
patients with high-quality care as well as laying the groundwork for professionalism, empathy,
and compassion in our nursing practice. These abilities are critical for building trusting
relationships with patients and delivering all-encompassing care.
Therapeutic Relationship
The goal of a therapeutic relationship is to support the patient in making positive changes in their life
through treatment. Since it's frequently the first environment in which the patient receives treatment
discusses personal ideas, convictions, and feelings about the issue(s) at hand, this kind of relationship is
crucial. Because of this, it's critical that the therapist creates a setting that is open, judgment-free, and safe
so that the person being affected feels comfortable.
Congruence, trust, and respect are essential elements of a successful therapeutic alliance. It is
encouraged for therapists to be sincere and empathetic. The therapeutic relationship contains limits that
aid in defining what behavior is acceptable and undesirable, just like any other social connection.
Components of a Therapeutic Relationship
Key components needed to develop a therapeutic relationship include trust, respect,
showing a genuine interest, and empathy. Following a pre-interaction phase, which is when the
nurse must become aware of her own personal feelings, fears, and worries about working with a
patient, there's an orientation phase. Regardless of the context, length of interaction and whether
a nurse is the primary or secondary care provider, these components are always present.
Together, these elements create a therapeutic relationship that advances recovery, raises patient
contentment, and boosts health results. They enable nurses to meet the emotional and
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psychological needs of the people they are caring for while delivering comprehensive, patient-
centered care.
Active listening: is paying close attention, expressing interest, and giving both verbal and
nonverbal clues that indicate comprehension.
Respect and Empathy: Respecting the patient's autonomy and dignity while also demonstrating
empathy by being aware of and understanding their thoughts, feelings, and viewpoints. Open and
transparent communication involves speaking plainly, staying away from jargon, and letting the
patient express themselves freely. This entails being clear about processes, treatments, and
results and presenting information in an understandable manner.
Non-verbal Communication: Expressing empathy, support, and understanding through
gestures, eye contact, and body language.
Reflective Responses: Making thoughtful comments that show acceptance and understanding
while validating the patient's emotions and experiences.
Trusting Behaviors by a Nurse
These trusting behaviors contribute to the establishment and maintenance of a therapeutic
relationship between a nurse and a patient. Trust is the foundation of effective communication,
collaboration, and overall patient satisfaction in healthcare settings.

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 Introduce yourself to your patient and use her name while talking with her. A handshake
at your initial meeting is often a good way to quickly establish trust and respect.
 Make sure your patient has privacy when you provide care. Be sure that her basic needs
are met, including relieving pain or other sources of discomfort.
 Actively listen to your patient. Make sure you understand her concerns by restating what
she has verbalized. For example, "Mrs. Smith, you mentioned that you were concerned that your
bone pain won't be addressed in a timely manner?" However, don't use restating too much in a
conversation because it can be perceived by your patient that you aren't really listening to her. Be
real, showing your genuine self when communicating with her.
 Maintain eye contact. Remember, too much eye contact can be intimidating. Smile at
intervals and nod your head as you and your patient engage in conversation. Speak calmly and
slowly in terms that she can understand. Your voice inflection should say "I care about you."
Maintain professional boundaries. Some patients need more therapeutic touch, such as
hand-holding and hugging, than others and some patients prefer no touching. Always respect
differences in cultures.
Roles of a Nurse In a Therapeutic Relationship
Therapeutic communication is face-to-face communication between a nurse and patient.
The three main purposes of therapeutic communication for a nurse are: (1) to provide education
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to patients, (2) to provide support to patients, and (3) to establish a relationship in which the
patient feels free to express any concern. These communication strategies involve providing
education and support to patients in an objective manner that will achieve the goal of
communication. The goal of therapeutic communication is to establish a relationship in which
the patient feels free to express any concern.
Nurses gain therapeutic communication skills through education and practice. A nurse with
proficiency in therapeutic communication can help a patient to feel comforted, cared for,
understood, and supported. Therapeutic communication can also help a patient to cope with a
situation and feel more relaxed. For these reasons, therapeutic communication is very important.
When the patient feels at ease, openness, trust, and a safe space are created which gives the
patient the best experience possible, improves clinical outcomes, and improves patient
satisfaction.
Therapeutic Communication
Therapeutic communication refers to the process of interacting with patients in a way that
helps to establish a positive relationship and supports the patient’s physical and emotional well-
being. It involves using specific communication techniques to create a supportive and empathetic
environment that encourages the patient to express their thoughts and feelings. This type of
communication is essential in healthcare settings as it can improve patient outcomes, enhance
patient satisfaction, and contribute to a more effective delivery of care.

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Therapeutic Techniques and Examples
Using Silence
At times, it’s useful to not speak at all. Deliberate silence can give both nurses and patients
an opportunity to think through and process what comes next in the conversation. It may give
patients the time and space they need to broach a new topic. Nurses should always let patients
break the silence.
Example: I practiced being with the patient in silence and providing a consoling presence
without using words.
Accepting
Sometimes it’s necessary to acknowledge what patients say and affirm that they’ve been
heard. Acceptance isn’t necessarily the same thing as agreement; it can be enough to simply
make eye contact and say “Yes, I understand.” Patients who feel their nurses are listening to
them and taking them seriously are more likely to be receptive to care.
Example: I actively listening to them and expressing my understanding through words like
“Yes, I understand” or nonverbal indicators like making eye contact, nurses demonstrate to
patients that their feelings are being recognized.
Giving Recognition
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Recognition acknowledges a patient’s behavior and highlights it without giving an overt
compliment. A compliment can sometimes be taken as condescending, especially when it
concerns a routine task like making the bed. However, saying something like “I noticed you took
all of your medications” draws attention to the action and encourages it without requiring a
compliment.
Examples: In my experience as a student nurse, it is important to recognize and emphasize
the patient’s conduct without necessarily praising or complimenting them outright. While
acknowledging a patient’s actions such as taking their medication or completing daily tasks helps
reinforce positive behaviors without coming across as patronizing, praises can occasionally
appear patronizing.
Offering Self
Hospital stays can be lonely, stressful times; when nurses offer their time, it shows they
value patients and that someone is willing to give them time and attention. Offering to stay for
lunch, watch a TV show, or simply sit with patients for a while can help boost their mood.
Examples: As a student nurse, I am aware of the psychological effects that hospital stays
have on patients and how showing time or company to them shows empathy, worth, and concern.
As a nurse, I know that being in the hospital can be a stressful and isolating experience for our
patients. Therefore, I try to be there and show them that they are not alone in their journey and
that they are valued.

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Giving Broad Openings
Therapeutic communication is often most effective when patients direct the flow of
conversation and decide what to talk about. To that end, giving patients a broad opening such as
“What’s on your mind today?” or “What would you like to talk about?” can be a good way to
allow patients an opportunity to discuss what’s on their mind.
Examples: In my role as a student nurse, I gain experience in therapeutic communication
facilitation, which entails letting my patients take the initiative and share their worries, ideas, and
feelings. As student nurses, we learn the value of allowing patients to lead the conversation by
actively listening to what they have to say and paying close attention to what they have to say.
Active Listening
By using nonverbal and verbal cues such as nodding and saying “I see,” nurses can
encourage patients to continue talking. Active listening involves showing interest in what
patients have to say, acknowledging that you’re listening and understanding, and engaging with
them throughout the conversation. Nurses can offer general leads such as “What happened
next?” to guide the conversation or propel it forward.
Example: As nurse acquiring the ability to utilize these strategies is crucial for efficient patient
communication as a nursing student. As student nurses, we may improve the quality of care by
encouraging open communication and a patient-centered approach by using active listening skills
to establish rapport, trust, and understanding with our patients.

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Seeking Clarification
Similar to active listening, asking patients for clarification when they say something
confusing or ambiguous is important. Saying something like “I’m not sure I understand. Can you
explain it to me?” helps nurses ensure they understand what’s actually being said and can help
patients process their ideas more thoroughly.
Example: One of the most important things a student nurse can do to promote good
communication, avoid miscommunications, and deliver high-quality, patient-centered care is to
become proficient at asking for clarification.
Placing the Event in Time or Sequence
Asking questions about when certain events occurred in relation to other events can help
patients (and nurses) get a clearer sense of the whole picture. It forces patients to think about the
sequence of events and may prompt them to remember something they otherwise wouldn’t.
Example: To become proficient in this technique as a student nurse, we have to actively
help patients in arranging their ideas and experiences in a logical order.
Making Observations
Observations about the appearance, demeanor, or behavior of patients can help draw
attention to areas that might pose a problem for them. Observing that they look tired may prompt
patients to explain why they haven’t been getting much sleep lately; making an observation that
they haven’t been eating much may lead to the discovery of a new symptom.
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Example: As student nurses getting important skills from learning observation as a
therapeutic communication approach that helps them understand patients better, provide
individualized care, and improve communication beyond spoken exchanges.
Encouraging Descriptions of Perception
For patients experiencing sensory issues or hallucinations, it can be helpful to ask about
them in an encouraging, non-judgmental way. Phrases like “What do you hear now?” or “What
does that look like to you?” give patients a prompt to explain what they’re perceiving without
casting their perceptions in a negative light.
Example: Understanding how to help patients express their perceptions can help you as a
student nurse to deliver more patient-centered care by recognizing each patient’s individual
needs and experiences.
Encouraging Comparisons
Often, patients can draw upon experience to deal with current problems. By encouraging
them to make comparisons, nurses can help patients discover solutions to their problems.
Example: Learning to apply this strategy as a student nurse necessitates tact and a thorough
comprehension of the patient’s surroundings. Encouraging comparison, when employed with
consideration and decency, may be a potent technique in therapeutic communication, supporting
the patient’s understanding, introspection, and advancement on their path to healing.

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Summarizing
It’s frequently useful for nurses to summarize what patients have said after the fact. This
demonstrates to patients that the nurse was listening and allows the nurse to document
conversations. Ending a summary with a phrase like “Does that sound correct?” gives patients
explicit permission to make corrections if they’re necessary.
Example: By carefully recording and commenting on the patient’s narrative, developing
your summarizing skills in therapeutic communication as a student nurse will improve your
capacity to communicate, establish rapport, and guarantee thorough patient care.
Reflecting
Patients often ask nurses for advice about what they should do about particular problems or
in specific situations. Nurses can ask patients what they think they should do, which encourages
patients to be accountable for their own actions and helps them come up with solutions
themselves.
Example: Reflection is a crucial therapeutic communication skill that student nurses should
acquire. In order to demonstrate comprehension and empathy, it entails reflecting the patient’s
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feelings, ideas, or emotions. Nurses establish a stronger connection by validating and clarifying
the patient’s experiences through paraphrasing or restating what the patient has spoken.
Focusing
Sometimes during a conversation, patients mention something particularly important. When
this happens, nurses can focus on their statement, prompting patients to discuss it further.
Patients don’t always have an objective perspective on what is relevant to their case; as impartial
observers, nurses can more easily pick out the topics to focus on.
Example: Gaining proficiency as a student nurse will make you more skilled at focusing on
patient issues, leading insightful discussions, and providing more individualized and efficient
treatment.
Confronting
Nurses should only apply this technique after they have established trust. It can be vital to
the care of patients to disagree with them, present them with reality, or challenge their
assumptions. Confrontation, when used correctly, can help patients break destructive routines or
understand the state of their situation.
Example:
Voicing Doubt
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Voicing doubt can be a gentler way to call attention to the incorrect or delusional ideas and
perceptions of patients. By expressing doubt, nurses can force patients to examine their
assumptions.
Example:
Offering Hope and Humor
Because hospitals can be stressful places for patients, sharing hope that they can persevere
through their current situation and lightening the mood with humor can help nurses establish
rapport quickly. This technique can keep patients in a more positive state of mind.
Example:
Different Techniques to Facilitate Nursing Process
Nurses process is a methodical approach called the nursing process to ensure that patients receive
the best care possible. There are several steps involved in this process, such as diagnosis, planning,
execution, assessment, and evaluation. A variety of strategies can be used to support the nursing
process and guarantee effective and efficient patient care.
Successful Interaction
For the nursing process to be facilitated, effective communication is crucial. Effective
communication is essential for nurses to obtain pertinent data during the assessment phase, explain the
care plan, and give education to patients, their families, and other members of the healthcare team.
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Active listening, open-ended questioning, and therapeutic communication are a few strategies that can
improve the relationship between a nurse and patient as well as the nursing process as a whole.
Technology Use
The way that technology is used in healthcare has had a big impact on the nursing process.
Medicine, mobile health apps, and electronic health records (EHRs) have all improved patient
information access, streamlined paperwork, and eased provider-to-provider communication. Nurses
can monitor vital signs, track patients' progress, and access evidence-based practice guidelines with
the help of technology, which improves nursing process efficiency.
Skills for Critical Thinking
A vital ability that makes nursing easier is critical thinking. Nurses need to be able to prioritize
care according to patient needs, analyze complex situations, and make clinical decisions. Through the
application of critical thinking skills like problem-solving, decision-making, and clinical reasoning,
nurses can confidently and precisely move through the various stages of the nursing process.
Cooperation and Unity
Cooperation between medical professionals is essential to enabling the nursing process.
Multidisciplinary collaboration guarantees that every facet of patient care is thoroughly attended to.
Strategies like routine team meetings, care coordination, and respect for one another among team
members encourage productive cooperation and help ensure that the nursing process is carried out
smoothly,
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Instruction for Patients
A crucial aspect of the nursing process involves educating patients about their conditions,
treatment options, and self-care techniques. Patients can be empowered to take an active role in their
own care through strategies like interactive teaching methods, clear explanations, and visual aids.
Patients are more likely to follow treatment plans and take an active role in their own recovery when
they are well-informed.
Time-Management Techniques
Nurses must effectively manage their time in order to complete each stage of the nursing process.
Prioritizing tasks, delegating when necessary, and making efficient use of resources are just a few of
the strategies that help nurses maximize productivity while meeting patient needs on time.
In conclusion, a variety of methods, such as technology use, critical thinking abilities,
cooperation and teamwork, patient education, and time management techniques, can be used to
support the nursing process. Nursing professionals can improve patient outcomes and provide high-
quality care by incorporating these strategies into their practice.
References:
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BUILDING TRUST WITH COUNSELING CLIENTS.

HTTPS://ONLINEDEGREES.BRADLEY.EDU/BLOG/BUILDING-TRUST-WITH-
COUNSELING-CLIENTS/#:~:TEXT=TO%20INTERACT%20WITH%20CLIENTS
%20AS,EMPATHY%20AND%20ACTIVE%20LISTENING%20SKILLS.
Chapter 2 Therapeutic Communication and the Nurse-Client Relationship

https://www.ncbi.nlm.nih.gov/books/NBK590036/#:~:text=Nurses%20use%20therapeutic
%20communication%20techniques,%2C%20goals%2C%20and%20coping%20strategies.
Nursing Process Tammy J. Toney-Butler; Jennifer M. Thayer

https://www.ncbi.nlm.nih.gov/books/NBK499937/
Therapeutic Communication Naveen P. Sharma; Vikas Gupta.

https://www.ncbi.nlm.nih.gov/books/NBK567775/#:~:text=In%20her%20text%2C
%20therapeutic%20communication,or%20psychological%20distress.%5B16%5D
Therapeutic Communication Techniques: How Good Nurses Can Provide Better Patient
Care for Best Results https://nightingale.edu/blog/therapeutic-communication.html
The Nursing Process: A Comprehensive Guide BY GIL WAYNE BSN, R.N.

HTTPS://NURSESLABS.COM/NURSING-PROCESS/#GOOGLE_VIGNETTE
THE IMPORTANCE OF A TRUSTING THERAPEUTIC RELATIONSHIP.

https://footscraycounsellingcentre.com.au/2019/08/05/the-importance-of-a-trusting-
therapeutic-relationship/#:~:text=How%20to%20Build%20Trust,to%20their%20feelings%20and
%20needs
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Psychiatric Mental Health Nursing : Therapeutic Relationships

https://www.brainkart.com/article/Roles-of-the-Nurse-in-a-Therapeutic-
Relationship_24212/#google_vignette

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1

United Church of Christ in the Philippines

Skills Laboratory Activity

Baliba, Joseph Michael N.

United Church of Christ in the Philippines

In the nursing profession, therapeutic communication is essential, particularly for student

emotional, and psychological needs by using effective communication techniques. This

knowledge makes it possible to provide more efficient and individualized care.

helps to clarify their

and decision-making by using therapeutic communication.

United Church of Christ in the Philippines

For us student nurses, developing therapeutic communication skills is crucial to providing

relationships with patients and delivering all-encompassing care.

so that the person being affected feels comfortable.

Components of a Therapeutic Relationship

Key components needed to develop a therapeutic relationship include trust, respect,

United Church of Christ in the Philippines

nonverbal clues that indicate comprehension.

results and presenting information in an understandable manner.

Non-verbal Communication: Expressing empathy, support, and understanding through

gestures, eye contact, and body language.

while validating the patient's emotions and experiences.

Trusting Behaviors by a Nurse

These trusting behaviors contribute to the establishment and maintenance of a therapeutic

collaboration, and overall patient satisfaction in healthcare settings.

United Church of Christ in the Philippines

are met, including relieving pain or other sources of discomfort.

real, showing your genuine self when communicating with her.

Roles of a Nurse In a Therapeutic Relationship