USE OF APPROPRIATE
COMMUNICATION
TECHNIQUES
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Communication
• reciprocal exchange of ideas
between or among persons
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Modes:
• Verbal - written/spoken
• Non-verbal - posture, tone
of voice, facial expression
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Types of Non-verbal communication:
Kinesis
body movement
eye contact
gestures
Paralanguage
voice quality
non-language vocalization (crying, sobbing,
moaning)
Proxemics – law of space relationship
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Touch – physical act
Cultural artifacts
eye glasses
uniform
beard
Meta communication
based on role expectations
hidden meaning of words
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Elements:
FE EDB AC K
Message
(Channel)
(Context)
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Therapeutic Communication
• A way of interacting in a purposeful
manner to promote the client’s ability
to express his thoughts and feelings
openly.
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Essentials for a Therapeutic
Communication
RE
G TA
Genuineness
Respect
Empathy
Attentive listening
Trust (rapport)
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Barriers to Therapeutic Communication
Belittling
Interrupting / ignoring B
Giving advice I
G
Social response
S
Changing the subject C
Approving / disapproving A
Moralizing M
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Therapeutic Communication
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• Accepting
– E.g. Yes, that must have been difficult for you.
• Acknowledging or giving recognition
– E.g. I noticed that you've fixed your bed.
• Asking direct questions
– E.g. How does your wife feel about your
hospitalization?
• Clarifying
– E.g. I'm not sure that I understand what you are
trying to say.
• Confronting or presenting reality
– E.g. I see no bats flying in this room.
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• Encouraging comparison
– E.g. Has this ever happened before?
• Encouraging description
– E.g. How do you feel when you take your
medication?
• Encouraging evaluation
– E.g. Does participating in group therapy
enable you to discuss your feelings?
• Exploring
– E.g. Tell me more about your job. Would you
describe your responsibilities?
• Focusing – assisting a patient to explore
specific topic 12
• Giving broad openings or asking open-ended
questions
– E.g. Is there something you'd like to do?
• Informing – giving needed facts
– E.g. I'll be your nurse for today, from 7:00 until
3:00 this afternoon.
• Making observations
– E.g. You appear to be angry. / I noticed that
you're trembling.
• Offering general leads
– E.g. Go on. / You were saying…
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• Restating
– E.g. Client: I can't sleep, I stay awake all
night. Nurse: You can't sleep at night,
(restating)
• Summarizing
– E.g. During the past hour, we talked about
your plans for the future, they include...
• Using silence - to induce thought, pacing,
acceptance
• Validating - confirming one's observation
– E.g. “So you mean . . .”
• Voicing doubt
– E.g. I find that hard to believe. 14
Non-therapeutic and
Ineffective Communication
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• Agreeing and disagreeing
– E.g. “I think you did the right thing.”
• Advice
– E.g. “You should.….”
• Belittling
– E.g. "Don't be concerned, evervone
feels like that".
• Defending
– E.g. "All doctors here are simply great".
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• False reassurance
– E.g. "Don't worry, everything will be all
right".
• Focus on caregiver’s feeling
– E.g. “I feel that way too.”
• Judging
– E.g. "It's your own mistake".
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Nurse –
Patient
Relationship
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P hases:
1. P rei nteracti on
2. Ori entati on
3. Worki ng
4. Termi nati on
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Pre-Interaction Phase
begins when the nurse is assigned/chooses a
patient
patient is excluded as an active participant
nurse feels certain degree of anxiety
includes all of what the nurse thinks and does
before interacting with the patient
Major task of the nurse: to develop self-
awareness
Other tasks: data gathering, planning for first
interaction
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Orientation phase
first interaction
establish of trust and rapport
learn about the patient and his initial concerns and
needs
establish contract with the patient
encourage the patient to feel comfortable with the
meeting
conduct initial interview
manage present emotion of the patient
provide support and empathy of the patient’s feelings
assure of confidentiality
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WORKING / THERAPEUTIC PHASE:
it is highly individualized
more structured than the orientation
phase
the longest and most productive phase
limit setting must be employed
Major task: identification and resolution
of the patient's problems
Other tasks: planning and
implementation
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Problems:
Transference
– the development of an emotional
attitude towards the nurse
– positive or negative
Counter transference –
experienced by the nurse /
therapist
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Termination Phase
Evaluate the summary of progress
Reinforce change and strength of
patient
Give rewards for the cooperation
during interaction
Encourage expression of feelings
about termination of the relationship
Terminate the relationship without
giving
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PROJECT: Choose a
partner
Choose 10 therapeutic
communication and 10 non-
therapeutic techniques and re-
enact each technique
Take a video, label what technique
is shown
This is worth 200 pts.
Submit on or before March 4, 2023.
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