Therapeutic Communication

Objectives

By the end of the lecture, students should be to:• Define therapeutic communication• Differentiate between verbal and non-verbal

communication• Discuss the components of communication• Explain effective communication skills• List the barriers to effective communication

Communication

• Complex process of sending, receiving and comprehending messages between two or more people

• Dynamic and on-going process• Creates a unique experience between the

participants• Skill that can be learned

Uses of Communication

• Demonstrate care

• Establish relationships

• Obtain information

• Assist with changing behaviour

NB: Therapeutic communication is foundational to the nurse-client relationship

Basic Communication Levels

Intrapersonal –occurs within an individual• Self talk-

• Internal discussion that takes place when an individual is thinking but nor verbalizing it

• Access client and or situation and critically think about it before verbalizing

Basic Levels CONT’D

Interpersonal – occurs between two people

• Most common in nursing

• Requires exchange of information with an individual or small group of people

Basic Levels CONT’D

Public – occurs with large groups of people

• Educational programmes

• Teaching in community settings

Basic Levels CONT’D

Transpersonal- addresses spiritual needs

• Provides interventions to meet the needs

Basic Levels CONT’D

Small group - within a group of people

Functional Components of Communication

• Referent -incentive or motive for communication

• Sender - Person who initiates the message

• Channel - method of transmitting and receiving the message (sight, hearing, touch)

• Receiver - person to whom message is aimed at

Functional CONT’D

• Environment- emotional and physical climate in which the communication took place

• Feedback- message returned to sender - Maybe verbal or non-verbal - Positive or negativeNB: Feedback is an essential component of

ongoing communication

Functional CONT’D

• Interpersonal variable- influence the communication between sender and receiver

Factors that Affect Verbal Communication

• Vocabulary- words• Denotative/connotative meaning- share

meaning• Clarity/brevity- short and simple• Timing/relevance- knowing when to

communicate• Pacing- rate of speech• Intonation- tone of voice

Non-Verbal Communication

- Assess the client’s non-verbal communication and meaning.- Attention to these are important• Appearance• Posture• Gait• Facial Expression• Eye contact

Non-Verbal CONT’D

• Gestures

• Sounds

• Territoriality

• Personal space

• Silence

Therapeutic Communication

Purposeful use of communication to build and maintain relationships with clients• Elicit and attend to client’s thoughts, feelings,

concerns and needs• Express empathy and genuine concern for

client and family• Obtain information and give feedback about

clients condition

Therapeutic CONT’D• Intervene to promote functional bahaviour

and effective interpersonal relationships

• Evaluates clients progress towards desired goals and outcomes

NB: 1. Children and older adults requires altered techniques 2. T. Comm. is required in the nursing process

X’tics of Therapeutic Communication

• Client –centered - (not social or reciprocal)

• Purposeful

• Planned

• Goal directed

Essential Components of Therapeutic communication

• Time• Attending bahaviour or active listening - Eye contact - Body language - Vocal quality - Verbal tracking• Caring attitude• Honesty• Trust• Empathy• Non-judgemental attitude

Children

• Use simple, straight forward language

• Be aware of non-verbal messages

• Be at child’s eye level

• Incorporate play

Older Adults

• Client may require amplification

• Minimize distraction and face the client when speaking

• Allow plenty of time for the client to respond

• When communication is impaired, ask for input from caregivers

Effective Communication Skills

• Silence- allows time for meaningful reflection

• Active listening- hear ,observe and understand

• Open-ended questions- allow clients to explore feelings

• Clarifying techniques- use to check if information is accurate: Restating, reflecting, paraphrasing, exploring

Skills CONT’D• General leads- start and continue talking

• Acceptance and recognition —interest and no judgment

• Focusing -conc. on what is important

• Asking questions - seek additional info.

• Giving info - provides details –decision making

Skills CONT’D

• Presenting reality - actual happening

• Summarizing - important points summary

• Offering self - relevant self disclosure

• Touch - communicate caring and comfort

Barriers to Effective Communication

• Asking irrelevant questions

• Offering personal opinions

• Giving advice

• Giving false assurances

• Minimizing feelings

Barriers CONT’D

• Changing the topic

• Asking ‘why’ questions

• Offering value judgment

• Excessive questioning

• Responding approvingly or disapprovingly