Chapter 10

Developing Therapeutic Relationships

Menu
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

F

Types of Relationships Social
q q q

Primarily for friendship or task accomplishment Needs are mutually met Communication - Often superficial

- Techniques: advice, meeting dependency needs

B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

F

Types of Relationships, cont. Intimate
q

Between two individuals with an emotional commitment to each other Mutual needs met Communication - Personal information - Intimate desires - Fantasies shared

q q

B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

F

Types of Relationships, cont. Therapeutic
q

Between nurse and client to enhance client growth Focus on client issues, problems, and concerns Communication

q q

- Therapeutic techniques used to identify and explore needs, set goals, assist in development of new coping skills, encourage behavioral change
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

F

Factors Enhancing Growth in Others
q

Genuineness
Congruence

q

Empathy

Understanding ideas expressed and feelings present in the other
q

Positive Regard

Implies respect: attitudes, actions (attending, suspending value judgments)
q

Helping Clients Develop Resources
Awareness, encouragement

B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

F

Boundary Blurring
Relationship slips into a social context Nurse behavior meets personal needs at expense of client:
q q q q q q

Underhelping Overhelping Controlling Narcissism Transference Countertransference
B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

F

Phases of the Nurse-Client Relationship
q

Preorientation
- Planning for the first interaction with client - Identifying nurse concerns

q

Orientation
- Compressed due to short hospitalizations; longer in community-based care - Issues: trust, parameters of relationship, contract, confidentiality, termination

B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

F

Phases of the Nurse-Client Relationship, cont.
q

Working - Tasks:
q q q

Maintain relationship Gather further data Promote client problem-solving skills, self-esteem and communication Facilitate behavioral change Overcome resistance behaviors Evaluate problems and goals and redefine prn Practice and express alternative adaptive behaviors B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

q q q q

Menu

F

Phases of the Nurse-Client Relationship, cont.
q

Termination
- Deal with intense feelings regarding the experience - Summarize goals and objectives achieved - Review client plans for future - Finalize termination

B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

F

Phases of therapeutic and nontherapeutic relationships

Slide 10-10
From Forchuk C. et al [2000]. The developing nurse-client relationship: Nurse’s Perspectives. Journal of The American Psychiatric Nurse’s Association, 6(1):3-10 Copyright © 2002 by W. B. Saunders Company. All rights reserved.

(Fig. 10-1) B Menu F

Factors Beneficial to Relationships
q

Consistent, regular, and private interactions with client - Consistency in assigned nurse - Regular routine of activities

q q q q q q

Being honest and congruent Letting client set the pace Listening to client concerns Positive initial attitudes and preconceptions Promoting client comfort and balancing control Client demonstrating trust and actively participating Menu B F in relationship
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Factors Hampering Relationships
q q q

Lack of nurse availability or lack of contact Lack of nurse self-awareness Nurse negative feelings about client

B
Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Menu

Sign up to vote on this title
UsefulNot useful