Handout #2: Therapeutic Communication
- Objective #14: Discriminate between hearing & listening
- More complex: ______
- Hearing: ______sound
- Listening: process that involves ______, ______, ______and ______to verbal messages.
- Listening challenges
- ______: internal & external
- ______out the message
- Rush to ______
- ______hearing
- Active listening
- ______
- ______contact, ______distractions, ______& observe
- ______
- ______language
- ______
- Paraphrase, ______
- Most important type of question: ______
- Defer ______
- Don’t ______
- ______: the process of remaining ______
- ______
- Course objective #15: Relate how therapeutic communication differs from social communication.
Therapeutic / Social
Who
Focus
Structure / Directed by the
Confidentiality
Client / Professional
Information
- Course objective #16: Define & describe the important of each of the following: readiness skills, attending skills, active listening skills, reflecting skills
- Readiness
- Establish therapeutic ______
- Choose a ______setting
- Attending
- 90% ______
- “You are ______it me”
- 4 Basic components
- ______
1)DO: Make ______contact ; Be ______aware; ______at the pt. frequently
2)DO NOT: ______
- ______
1)DO: ______
2)DO NOT: ______, ______
3)______the distance between 2+ people
- Intimate: ______
- Personal: ______
- Social:______
- Public: ______
- ______
- ______(encouraging)
1)Verbal: ______
2)Non-verbal: ______
- Active listening
- Verbal ______(Echoing)
- Finding a ______or two, towards the ______of the senders ______that you can use to ______more clarification or discussion.
- “My girlfriend is great with my son. She has really been a life-saver to both of us.”
- Echoing evaluation
- How accurately did you repeat your partner's words verbatim?
- How did you choose which words to repeat?
- What effect did verbal following have on the intensity and quality of your listening compared to silent listening or using minimal encouragers?
- What effect did verbal following have on how your partner disclosed information to you?
- At what point did you exceed your comfort level with verbal following?
- When might verbal following be a useful strategy with a client?
- What did you find easy about this activity?
- What did you find challenging?
- What do you need to work on improving with respect to verbal following?
- Reflecting / ______
- ______before you speak!
- Reflecting (______) statements
- ______communication
- Purpose
1)Convey ______, Build ______
2)Helps pt. ______information & express ______
- Rules
1)Only ______client; don’t ______
2)Listen for the ______
3)Reflect the ______& ______
- Practice
1)Depressed Patient: “I feel like just sleeping or doing nothing but I can’t sleep at night though. It’s ridiculous. Maybe it’s because I worry too much”
2)Child: “I went to my grandma’s and she wasn’t home”.
3)Patient: “ I hate being in this hospital”
4)Patient: ”I don’t want any students looking in my chart”
- Activity
adventurous / confused / guilty / mellow / skeptical
afraid / delighted / happy / misunderstood / startled
alert / depressed / hopeful / nervous / stupid
amazed / desperate / hopeless / nostalgic / sure
ambivalent / disappointed / hurt / numb / surprised
angry / disgusted / ignored / optimistic / tense
annoyed / easygoing / impatient / overwhelmed / tired
astonished / ecstatic / inadequate / patient / uncertain
belligerent / edgy / indifferent / peaceful / uncomfortable
bold / embarrassed / inspired / perplexed / unsure
burned out / exasperated / intimidated / pessimistic / vigilant
calm / excited / intrigued / positive / weary
capable / exhausted / irate / pressured / wistful
cautious / failure / irritated / proud / wonderful
challenged / fantastic / jealous / relieved / worried
comfortable / foolish / joyful / resentful
concerned / frenzied / lonely / resourceful
confident / frustrated / lost / restless
confined / funny / mad / sad
conflicted / gloomy / melancholy / scattered
- Activity Evaluation
1)How accurately did you identify the feelings communicated by your partner?
2)If a mismatch occurred between the feeling you perceived and the one your partner conveyed, what might account for the mismatch?
3)Which cues from your partner did you tend to use the most in helping you identify the feelings?
4)Which cues did you tend to use the least?
5)What did you find easy & what did you find challenging about this activity?
6)What do you need to work on improving with respect to perceiving and reflecting feelings?
- ______(Reflecting of ______)
- Use your ______words
- Help ______inconsistencies
- ______checking
- Prevents ______& ______
- Goal ______understanding
- Procedure
1)______: ______
2)Interpretation: Provide ______
3)Request ______
- Course objective #17 Explain the concept of therapeutic self
- Use of self - _____ therapeutic ______
- 3 Interventions of psychotherapeutic management
- Therapeutic ______
- Psycho ______
- ______management
- Objectivity: Undistorted by ______or personal ______
- Empathy: “Ability to ______& ______the patients ______and point of view ______”
EMPATHY / SYMPATHY
Accurately / Shares
Shared
Taking on other
Emotionally / Emotionally
- Describe and give examples of each of the following communication techniques and where they are commonly used in the nursing process.
- Giving information: Making available ______the patient needs
- Skill: ______
- Example: ______
- Giving recognition: Acknowledging, indication ______
- Better than a ______
- Skill: ______
- Example: ______
- Showing acceptance: Giving indication of ______
- Skill: ______
- Example: ______
- Offering of self: Making one’s self ______
- Types
- ______
- ______
- ______
- Example: ______
- Making observations: ______what is ______
- Skill: ______
- Example: ______
- General leads: Encouragement to ______
- Rule: ______
- Example: ______
- Broad openings: Allows the patient to take the ______in ______a topic
- ______
- Skill: ______
- Example: ______
- ______-ended questions: ______be answered with 1-2 words
- Encouraging descriptions of perceptions: Asking ______to ______what he perceives
- Helpful with ______
- Example:______
- Clarification: Seeking information to ______
- Examples: ______
- ______
- Avoid ______
- Helps pt. become more ______of their ______
- Reflecting: Directing back to the pt______, feelings & ideas
- Helpful: ______
- Restating: ______
- Repeating the ______
- Example:
- Exploring: ______further into a ______or idea
- Helpful: Patients who remain on a ______level of communication
- If a patient chooses not to delve ______
- Expanding ______
- Examples: ______
- Verbalizing the implied: ______what the patient has ______at or suggested
- Rules
- Make less ______
- Be ______
- Express only what is ______
- Helpful: ______or ______verbal communication
- Encouraging comparison: Asking that ______& ______be noted
- Example
- Translating into feelings: ______
- Find ______in the ______meaning
- Example: ______
- Sequencing
- Placing ______in sequence of______
- ______
- Gives ______
- Example: ______
- Stating reality: Offering consideration that which is ______
- Patient ______
- Nurse: Defines ______or perception
- Example: ______
- Voicing doubt: Expressing ______as to the ______of the patients perceptions
- Careful: ______
- Benefit: ______
- Examples: ______
- Focusing: Concentration on a ______point (______/ ______)
- Helpful: ______
- Example: ______
- Silence: ______of verbal communication
- Encourages: ______
- ______pace
- Give ______
- Silence is Golden: Multiple ______valuable ______
- Activity evaluation
- Estimate how long you listened silently before you became uncomfortable.
- Once you found yourself becoming uncomfortable, what did you do? What went through your mind?
- What effect did your silence have on how your partner disclosed information to you?
- How did you know your partner was finished talking before you asked a question or made a comment?
- Estimate your tolerance level for keeping silent (high, pretty good, fair, poor, none)
- What factors do you think affect your tolerance level for listening silently?
- What can you do to improve your tolerance for silent listening?
- Course Objective #19: Recognize and list non-therapeutic interventions
- Red flag words:
- ______
- ______
- ______
- ______
- ______
- ______
- ______
- Belittling, ______, mocking, ______
- Patient feels ______, ______validity of their feelings
- Examples: ______
- Giving ______responses
- Examples: ______
- Challenging: Demanding ______
- Examples: ______
- ______: Opposing the patients ideas
- Examples: ______
- Be non-______
- Word, ______& ______language
- ______: statement that show you believe the person is correct
- Examples: ______
- Results:
- Shuts ______
- Places value ______on behavior
- ______assume responsibility
- ______/ Justification: Counter replay to a verbal ______
- Nurse = ______
- Patient = intimidated & ______
- Examples: ______
- ______responses: ______
- Superficial
- Examples: ______
- Giving ______reassurance: Without ______
- AKA: ______
- Examples: ______
- Giving ______: Telling the patient ______
- ______
- ______
- Patient ______
- Examples: ______
- ______the subject: Introducing a ______topic
- Examples: ______
- Asking ______- ending questions: Questions with ______word answers
- Asking ______questions: Requesting an ______
- Put them on the ______
- ______: Seeking info beyond what is necessary
- Course objective #20: Recognize communication deficits in clients and teach appropriate social skills.
- Use ______words
- ______messages = ______
- ______messages = ______
- ______- ______- disrespect
- Guidelines for CONSTRUCTIVE feedback
- ______
- ______
- Be ______
- Explain ______
- Avoid ______
- Evaluate ______, not the performer
- Use ______knowledge
- ______on how to ______it happening again
- Giving Praise
- Be ______
- ______
- ______
- Area of ______
- Be ______
- “Touching” in therapeutic relationship
- What are the advantages of touching
- What are the disadvantages of touching
- When and where is it appropriate?
- When and where is it NOT appropriate?
Handout 210/18/20181