Therapeutic Communication Techniques

Stereotyping comments or social responses

"How ar you?" without any feeling, eye contact, or interest. Or "Nice weather today"

Requesting an explanation

("why" questions) asking client to provide the reasons for thoughts, feelings, behaviors, and events (this causes defensiveness) Nurse: "Why do you feel that way?

Blocks impeding therapeutic communication

AVOID USING

Closing

Statements at the end of an interaction that close in a meaningful way Nurse: "thank you for sharing with me. I have a better understanding of what you are going through. Please let me know if there is anything I can do of you right now"

Acknowledge

acknowledging what the client has said. Client: "You're late with my insulin" Nurse: "I am sorry"

Giving recognition

acknowledging, indicating awareness Nurse: "I see that you have fixed your hair today"

Encouraging comparison

asking that similarities and differences be noted Nurse: "How is this pain compared to what you experienced last night?"

Multiple questions

asking too many questions at one time

Assumptions

assuming how a client thinks or feels

Defending

attempting to protect someone or something from verbal attack Client: "Dr. James is a jerk!" Nurse: "Dr. James has a fine reputation"

Exploring

delving further into a subject or idea Nurse: "Tell me more about how you are feeling now"

Offering general leads

giving encouragement to continue. Includes nonverbal such as head nodding and paralanguage such as "uh huh" Nurse: "Go on." "And then..." "Tell me.."

False reassurance or reassuring cliches

indicating that there is no cause for worry. Nurse: "I'm sure everything will be all right"

Leading subjects

leading the client into a response Nurse: "You're not angry at the doctor anymore, are you?"

Giving information

making available the facts that the client needs "It is unlikely that you will be able to go home until you have finished these new tests that your doctor told you about"

Offering self

making oneself available Nurse: "I will stay with you until your daughter gets here"

Belittling feelings expressed

misjudging the degree of the client's discomfort Nurse: "everyone feels that way sometimes"

Broad opening statement

opening statement or question to begin rapport Nurse: Good morning Mr. Smith. How are you feeling today? (said with presence and eye contact)

Summarization

organizing and summing up that which has gone before Nurse: "during the past hour, you and I have discussed"

Probing

persistent questioning of the client in an area the client does not wish to discuss

Restatement

repeating the main idea expressed Client: "I hate this hospital" Nurse: "You hate this hospital"

Giving approval or agreeing

sanctioning the client's ideas or behavior "that's the right attitude" or agreeing "that's right"

Sharing

sharing your personal experiences AS APPROPRIATE. Use sparingly and only when appropriate. This technique must be used for the client's benefit and not to meet the nurse's needs. Can easily be a block

Giving advice

telling a client what to do nurse: "I think you should have the surgery"

Paraphrasing

transforming the client's words into the nurse's words, keeping the meaning intact Client: "This is really not fair. I am only 24 years old and now I am dying" Nurse: "It doesn't seem right or fair when you are so young to be facing this

Using silence

utilizing absence of verbal communication

Making or sharing observations

verbalizing what is perceived Nurse: ""I see that you have fixed your hair today"

Verbalizing the implied

voicing what the client has hinted or suggested Client: "I can't talk to anyone" Nurse: "It sounds like you think no one understands"

Closed questions

yes/no answer questions are blocks unless the nurse needs specific and pertinent information that cannot be obtained using a technique

Focusing

concentrating on a single pont Nurse: "The point you made about the nursing home was interesting; please talk a little more about that. OR I'd like to hear more about that"

Rejecting or disapproving

denouncing the client's behavior or ideas "that's a bad attitude" or rejecting "let's not discuss that"

Reflection

directing back to the client feelings, ideas, or questions Client: "I can't get out of the hospital to see my kid's school program. This is the third event I've missed. My kids say it's okay, but I'm not so sure." Nurse: "You're feeling frustrated and guilty because you are missing important family events and you have no control over it"

Encouraging description of perception

encouraging client to describe how he sees the situation, and its meaning for him Nurse: "What is your understanding about what the doctor just shared with you? What does this mean for you and your family right now?"

Changing the subject

introducing an unrelated topic Client: "I want to die" Nurse: "Oh, dear, did you have company last weekend?"

Seeking validation

searching for mutual understanding Nurse: "you seem to be feeling better now after your bath." or "I believe you are telling me that..."

Clarification

seeking to make clear that which is not meaningful or that which is vague Nurse: "I'm not sure that I follow..."

Interpreting

seeking to make conscious that which is unconscious or telling the client the meaning of the experience Nurse: "What you really mean is..."