Therapeutic communication - PowerPoint

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					 Therapeutic
Communication
The Helping Interview
       Helping Relationship
         Characteristics
 Caring             Empowering
 Hopeful            Teaching

 Sensitive          Goal- Oriented,

 Genuine             Purposeful
 Empathy            Time Limited

 Positive Regard    Assertive

 Values Self &
  Others
Helping vs Social Relationships
   HELPING                     SOCIAL
   Care                        Care
   Trust                       Trust
   Growth                      Growth
   Purposeful/Intentional      Spontaneous
   Unequal Sharing             Similar Sharing
   Focus on Client’s           Focus on Needs of
    Needs                          Both Individuals
   Time Limited                Ongoing
                        Control
   GIVING HELP                NEEDING HELP
   feeling important          feeling unimportant or
   feeling useful              inadequate
   feeling powerful           feeling useless or
   feeling gratified           depressed
   feeling happy              feeling powerless
                               feeling frightened or
                                embarrassed
                               feeling sad or angry
Phases of Helping Relationship
 Orientation(professional and client
  to each other)

 Working   (identification of the
  client’s problem)

 Termination  (resolution of the
  client’s problem)
         Orientation Phase
 “getting  to know you” phase
 sets the tone

 introductions

 roles

 initiated by the nurse

 agreement/contract/goals

 trust develops
               TRUST
T   try expression
R   reflection
U   use of silence
S   setting limits
T   time with client
           Working Phase
 “problem    solving” phase
 attend to client’s needs

 role of teacher/counselor

 client actively participates

 gather further data

 facilitate change

 evaluate problems & goals
             Termination
 “ending” phase
 review and summarize progress &
  goals met/not met
 acknowledge feelings

 use clear language

 check the receiver understands

   the message sent
             Resolution
        mostly seeking explanation
 clients

 how will problem affect their lives?

 what will need to be changed?

 how will they cope?
                  Avoid
 arguing               “selling” client on
 minimizing             accepting
 challenging
                         treatment
                        probing sensitive
 giving false
  reassurance            areas
                        participating in
 interpreting or
  speculating on the     criticism of any
  dynamics of the        staff member
  client’s problems     joining any attacks
                         led by client
    Nursing Interventions to Encourage
         The Helping Relationship

 active listening
 therapeutic communication techniques

 other factors
      attentive listening scale
 hard to maintain eye contact
 respond before other finishes speaking

 finish other people’s sentences

 talk on and on so no one can respond

 go on working while someone is talking to
  you
 repeat a point just made

 allow your mind to wander during a
  conversation
            good listening
 STOP TALKING
 put the speaker at ease
 show that you want to listen
 remove distractions
 empathetic
 be patient
 hold your temper
 go easy on argument and criticism
 STOP TALKING
   communication techniques
 open  ended questions (closed for
  obtaining specific information)
 validating/clarifying

 reflective/restating & paraphrasing

 sequencing

 sharing observations

 acknowledging feelings
        interpersonal skills
 warmth  and friendliness
 openness (acceptance)
 consideration of client variables
  – non-english speaking
  – developmental considerations
  – older adults
  – sociocultural
  – occupational
  – patients with special needs
     other factors promoting
   therapeutic communication
 comfortable   environment
 Providing some personal space

 privacy

 confidentiality

 client focus

 optimal pacing

 nursing observations
       blocks to communication
   failure to respect        why & how
    client                    probing
   failure to listen         changing the subject
   minimizing feelings       leading questions
   inappropriate             advice
    comments & questions      judgmental
   excessive questions       false reassurance
   yes/no questions          giving
                               approval/disapproval
    therapeutic vs non-therapeutic
     THERAPEUTIC                   NON-THERAPEUTIC
   facilitates                   hinders relationship
                                   formation
    transformation of
                                  prevents patient from
    working nurse/patient          becoming mutual partner
    relationship                   & relegates him/her to
   relationship allows for        passive recipient of care
    adequate & accurate
    assessment &
     data collection
   performed with
    patient, not for patient
          disclosure, yes or no?
   use self disclosure to       monitor your own
    help clients open up to       comfort with
    you – not to meet              self-disclosure
    your own needs               respect your client’s
   keep your disclosures         needs for privacy
     very brief                  remember that there
   don’t imply that your         are cultural variations
    experience is exactly         in the amount of self-
    the same as                   disclosure considered
    the client’s                  appropriate
   only self-disclose           identify risks and
    about situations that         benefits of
    you have mastered             self disclosure
                                 discuss the goals of
medical care is not enough!


We need more than medical
care or surgery--we need
competent care &
a good communicator

				
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posted:7/30/2012
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