Therapeutic versus Non-Therapeutic Communication Techniques

SOLER

S- Sit facing the patient O- Open position (keep arms and legs uncrossed) L- Lean toward the patient E- Eye contact R- Relax

Therapeutic Communication Techniques

Specific responses that encourage the expression of feelings and ideas and convey acceptance and respect.

Non-Therapeutic Communication

Certain communication techniques that hinder or damage professional relationships. Also known as blocking

Summarizing

- Concise review of key aspects of an interaction -Bring a sense of satisfaction and closure to an individual conversation -Beginning a new interview by summarizing a previous one helps the client recall topics discussed

Approval or Disapproval

- Do not impose your own attitudes, values, beliefs, and moral standards on others while in the professional helping role. -Approving implies that the behavior being praised is the only acceptable one. -Disapproval implies that the patient need to meet your expectations or standards. Example: "You shouldn't even think about assisted suicide; it's not right."

Automatic Response

- Making stereotyped remakes about others reflects poor judgement and threatens the nurse-patient or team relationships -Parroting: Repeating what the other person has said word for word. -A nurse who is task oriented automatically makes the task or procedure the entire focus of interactions with patients, missing opportunities to communicate with them as individuals and meet their needs. Example: "Older adults are always confused." "You can't win them all."

Asking Personal Questions

- Not relevant to the situation simply to satisfy your curiosity is not appropriate professional communication -Nosy, invasive, unnecessary Example: "How would you describe your relationship with John?"

Sharing Empathy

-Ability to understand and another person's reality, accurately perceiving feelings and communicate this understanding to others. Example: a nurse says to an angry patient who has low mobility after stroke, "It must be very frustrating to not be able to do what you want."

Using Touch

-Because of modern fast-paced technical environments in health care, nurses face major challenges in bringing the sense of caring and human connection to their patients. -One of the most potent and personal forms of communication. -Nurses need to be aware of patients' nonverbal cues and ask permission before touching them to ensure that touch is an acceptable way to provide comfort

Defensive Response

-Becoming defensive in the face of criticism implies that the other person has no right to an opinion. -When a patient expresses criticism, listen to what they have to say. Listening does not imply agreement. Example: "No one here would intentionally lie to you."

Active Listening

-Being attentive to what a patient is saying both verbally and nonverbally. -Active listening enhances trust because you communicate acceptance and respect for a patient.

Anger

-Challenging or arguing against perceptions denies that they are real and valid. -A skillful nurse gives information or present reality in a way that avoids argument. Example: "How can you say you didn't sleep a wink when I heard you snoring all night long?"

Changing the Subject

-Changing the subject when another person is trying to communicate his or her story is rude and shows a lack of empathy. -Blocks further communication, and the sender then withholds important messages or fails to openly express feelings. Example: "Let's not talk about your problems with the insurance company. It's time for your walk."

Sympathy

-Concern, pity, or sorrow felt for another person. -Subjective look at another person's world that prevents a clear perspective of the issues confronting that person. Example: "I'm sorry about your mastectomy; you probably feel devastated."

Sharing Feelings

-Emotions are subjective feelings that result from one's thoughts and perceptions. -Sharing emotion makes nurses seem more human and brings people closer. It is appropriate to share feelings of caring or even cry with others, as long as you are in control of the expression of these feelings and express them in a way that does not burden that patient or break confidentiality.

Focusing

-Focusing involves centering a conversation on key elements or concepts of a message Example: We've talked a lot about your medication: now let's look more closely at the trouble you're having in taking them on time."

Sharing Humor

-Humor is an important but important but often underused resource in nursing interactions. -It provides emotional support to patients and professional colleagues and humanizes the illness experience.

Using Silence

-It takes time and experience to become comfortable with silence. -In general, allow a patient to break the silence, particularly when he or she has initiated it. Example: It helps a patient gain the necessary confidence to share the decision to refuse medical treatment.

Asking Relevant Questions

-Nurses ask relevant questions to seek information needed for decision making. Ask only one question at a time and fully explore one topic before moving to another area. -Asking too many questions is sometimes dishumanizing. Seeking factual information does not allow a nurse or patient to establish a meaningful relationship or deal with important emotional issues.

Sharing Observations

-Nurses make observations by commenting on how the other person looks, sounds, or acts. -Sharing observations differs from making assumptions, which means drawing unnecessary conclusions about the other person without validating them. Example: "I see you did not eat any breakfast...," "You look tense...," or a positive observation such as "I see you have been organizing your photos...."

Sharing Hope

-Nurses recognize that hope is essential for healing and learn to communicate a "sense of possibility" to others. -Sharing a vision of the future and reminding others of their resources and strengths also strengthens hope. Examples: A nurse says to a patient discouraged about a poor prognosis, "I believe that you'll find a way to face your situation because I've seen your courage creativity."

Paraphrasing

-Paraphrasing is restating another's message more briefly using one or two words. -Through paraphrasing you send feedback that lets a patient know that he or she is actively involved in the search for understanding. Example: A patient says, "I've been overweight my whole life and never had any problems. I can't understand why I need to be on a diet." Paraphrasing this statement by saying, "You're not convinced that you need a diet because you've stayed healthy."

Passive Aggressive Responses

-Passive responses serve to avoid conflict or sidestep issues. -Aggressive responses provoke confrontation at the other person's expense. -Assertive communication is a far more professional approach for a nurse to take. Example: "things are bad, and there's nothing I can do about it." "Things are bad, and it's all your fault."

Providing Information

-Providing relevant information helps your patients make decisions, experience less anxiety, and feel safe and secure. -Speak in simple language, and translate medical terms. When offering options, stress that the patient has the right to make decisions. Example: The nurse explains, "Roberto, this pain medication may make you feel a little sleepy and groggy at first, but those side effects usually go away after 2 or 3 days."

Asking for Explanations

-Some nurses are tempted to ask patients why the believe, feel, or act in a certain way. -Patients frequently interpret "why" questions as accusations or think nurses know the reason and are simply testing them. Example: "Why are you so anxious."

Self-Disclosure

-Subjectively true, personal experiences about self that are intentionally revealed to another person. -You chose to share experiences or feelings that are similar to those of the patient and emphasize both the similarities and differences.

Validation

-The is a technique that nurses use to recognize and acknowledge a patient's thoughts, feelings, and needs. Example: A nurse validates the patient's stated comments by asking, "Tell me if I understand your concerns regarding your surgery. you're worried that you will not be able to return to your usual way of life."

Clarifying

-To check whether understanding is accurate, restate an unclear or ambiguous message to clarify the sender's meaning. Example: "I am not sure I understand what you mean by 'sicker than usual.' What is different now?"

False Reassurance

-When a patient is reaching for understanding, false reassurance discourages open communication. Example: Don't worry, everything will be alright." -A more facilitated response: "It must be difficult not to know what the surgeon will find. What can I do to help?"

Confrontation

-You help the other person become more aware of inconsistencies in his or her feelings, attitudes, beliefs, and behaviors. -Improves patient's self-awareness and helps them recognize growth and deal with important issues.

Giving Personal Opinions

When a nurse gives a personal opinion, it takes decision making away from the other person. It inhibits spontaneity, stalls problem solving, and creates doubt Example: "If I were you, I'd out your mother in a nursing home."