Discussion: Therapeutic Communication
Introduction: Therapeutic Techniques in psychiatric nursing
Therapeutic use of self refers to the ability of a person to consciously attempt to establish readiness to structure a nursing intervention. Nurses as care providers need to possess self-understanding and self-awareness about the overall human condition to implement therapeutic use of self (Keltner & Steele, 2018). Therapeutic relationship between nurse and a client requires rapport, respect, genuineness, trust and empathy. Interaction is also enhanced when nurses utilizes effective communication strategies (Bohart & Wade, 2013). Besides, establishing a trusting relationship is important in winning the confidentiality of the client so that they can openly discuss their thoughts and feelings about a given care practice. Nurse-patient relationship is enhanced through communication as well as interaction. Therapeutic techniques enables client to set goals towards achieving a behavioral change that guarantee quality outcomes (Mohammed & Yas, 2016). Nurses ought to understand that certain behaviors occur in clients frequently due to nervous mannerisms or those related to social expectations. A psychiatric nurse need to recognize as well as overcome habitual communication behavior potential in compromising quality care.
First Technique: Techniques Fostering Description
Care setting can be challenging to patients. Nurse should offer self to address the stressful situations encountered by clients. The actions indicate respect and value given to patients for their willingness to participate in therapy. A nurse can offer her time by willing to stay for lunch with the client or request the latter if they could watch television of walk together. These are not acts of submission but the intentions are very clear- to build a rapport with the client so that the avail information necessary for care. Through the interaction with the client, the nurse should employ active listening strategies (Webster, 2014). This entails the use of verbal and non-verbal cues to encourage the client to talk more as a way to reveal all the potential challenges regarding the subject matter of discussion. Active listening also entails having an interest in the information communicated by the client to support an initiative in the change process.
Communication involves participants from both sides providing their views about a given subject matter. As a thumb of rule for communication, the nurse need to establish an environment of positive communication to allow the client seek for clarity in case of a misunderstanding. Nurses should as well probe clients to affirm if the concepts discussed are understood by them (Keltner & Steele, 2018). The level of engagement with the client should offer a chance for the development of change process about a given psychological issue. This only happens when the strategies for change are addressed in a simple but yet clear manner. Clients should also gain recognition that they have been heard. The sessions between the client and the nurse should guarantee acceptance for change in behavior. Nurse and client should make direct eye contact to affirm and confirm that the topics addressed are understood. Patient’s behavior should also be clearly understood by the nurse to enable the latter offer solution that is satisfactory to the former.
Second Technique: Techniques Fostering Analysis and Conclusions
Patients diagnosed with mental conditions may not find it comfortable to communicate their experience. At times, they may not have clear illustrations of the subject matter relating to their behavior. As such, nurse should offer support by making their engagement comfortable. Questions like “What do you hear when you sleep at night?” and “What does that look to you?” should be used commonly to ensure that they communicate their actual feeling. Nurses should encourage them to reveal more of the events or episodes experienced by the clients (Bohart & Wade, 2013). Patients especially those experiencing hallucinations should be encouraged to express their feelings. However, nurses should be non-judgmental about matters expressed by the clients (Townsend & Morgan, 2017). Casting their perception with doubt may also prompt the client from communicating their concern. Encouraging descriptions of perception also involves giving patient hints about manifestations of mental problems. This will enable them indicate if they have experienced any of the symptoms related to hallucination or depression to diagnose a mental health issue.
It is imperative for the client to indicate when they first experienced a mental condition and how long they have batted the problem. Statement like “When did this occur?” and “How long have you experienced the issue?” may form part of the questions when a nurse is assessing time or sequence of events (Keltner & Steele, 2018). Nurse should also explain about certain events to remind the clients about their experience at that time. For example question the clients about where they celebrated their last birthdays, Christmas or Thanksgiving and whom did they spend it with. Probe the client to reflect deep in their mind about how some events turned around and their reaction or perception to such occurrences. The nurse need to summarize the information communicated by the client and select the best that can be used to provide intervention. This will enable the client to understand that the nurse was keenly listening and documenting their conversations.
Third Technique: Techniques Fostering Interpretation of Meaning and Importance
Patients can provide various experiences with their current problem by reflecting upon earlier experiences. Nurse should encourage patients to provide a comparison feedback about their previous experiences with the current perception. This enables the nurse to assess their status and evaluate behavioral pattern before developing a therapy plan (Mohammed & Yas, 2016). Often, mental health issues reflects a sequence of behavioral changes in which one event can be used to diagnose or predict another event.
Nurses should also focus their communication with the client by mentioning concepts that are very important to the topic of discussion. They could ask the type of medications they are currently taking. Patients may not have objective perspective about their condition and it is the role of the nurse to narrow down discussion relevant to the patient’s case (Stuart, 2014). Nurse may also act as an impartial observer but should select the topics that also interest the client. When nurses focus on addressing the subject matter, statements relevant to case of the patient may be discussed so as to design an intervention for improving outcomes.
Fourth Technique: Techniques Fostering Problem-Solving and Decision-Making
Solution to a given challenge will depend on concerted efforts between the nurse and client. Besides, patient’s surrogates may also be involved in the entire decision process. This calls for a collaborative effort among different players. The nurse must communicate a plan of care in collaboration with the patient and other care givers. The decision on a choice of intervention should also be communicated to ensure that the patient accepts the process. Clients should be given a chance for them to communicate their perspectives on care (Fortinash & Worret, 2014). This implies that the nurse should explain the available treatment options and which one guarantees quality outcomes at relatively low prices. Selection of the therapy options should also be left at the discretion of the client. Nurses should respect the option and support the client in deriving benefits by implementing evidence-based practice to support the care process. Attention should also be made to patients about benefits and disadvantages of the selected therapy option.
Fifth Technique: Techniques Fostering Completion of Plans
The entire process of care can be stressful to patient. There is a need for nurses to rehearse the care process before implementing the same with the client. Most importantly, the communication process can be rehearsed between the client and the patient. Encourage the client to take up tasks especially those that address their specific conditions. The entire process of rehearsal is aimed at maximizing care by first examining assumptions before making a decision on care (Townsend & Morgan, 2017). It is also an avenue to offer hope to the client about their perspective on care. Through role playing, the patient’s current situation is shared. The nurse also develops rapport quickly to encourage them adhere to the selected therapy plans. This gives hope to client that the nurse take keen interest in their condition and is committed to their quality outcomes. Besides, the role playing process builds a positive mind among the patients to motivate them in providing solutions to address their own challenges.
Upon the development of a care plan, it is important to encourage patients to adhere to the intervention option. Nurses should first educate the patient about the selected therapy option to support their decision on adoption (Sherko, Sotiri & Lika, 2013). It is also important for nurses to communicate the various options on care that guarantees quality outcomes. Upon the selection a suitable option, nurses should reinforce the need to adhere to the given therapy plan. This entails communicating the benefits of the plan in addressing the condition of the client (Davis Boykins, 2014). Patients should be informed about the negative consequences that would arise if the therapy plan is not followed to the latter. A feedback should also be communicated by the nurse to patient regarding a given behavior change. This major entail addressing aspects of care that would guarantee quality to patients. If there is a need for behavioral adjustments, then the nurse should communicate the same to the client and monitor their progress.
Therapeutic techniques is a communication between a nurse and a client to help the latter solve a given psychological issue. The focus is to enable the client identify their problem and formulate their own solutions to address the subject matter. Through communication, nurse initiates and elaborates the needs and interventions aimed at proving solution to the identified problem. As a rule to instill confidence, nurses should establish a rapport with the client and assure them of confidentiality of the information communicated. The client also needs a confirmation that the present problem will be addressed amicably. Any feelings expressed by the client should be used by the nurses as steps for developing communication plans. However, the nurse need to be active listeners, sensitive to patients and have a sense of humor to motivate the client in sharing feelings. Nonetheless, the engagement between the client and the nurse should instill a positive effect and ensures that the patient understands the entire process essential for a change in behavior.
Bohart, A. C., & Wade, A. G. (2013). The client in psychotherapy. Bergin and Garfield’s handbook of psychotherapy and behavior change, 6, 219-257.
Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard (2014+), 29(14), 53.
Davis Boykins, A. (2014). Core communication competencies in patient-centered care. ABNF Journal, 25(2).
Fortinash, K. M., & Worret, P. A. H. (2014). Psychiatric Mental Health Nursing-E-Book. Elsevier Health Sciences.
Keltner, N. L., & Steele, D. (2018). Psychiatric Nursing-eBook. Elsevier Health Sciences.
Mohammed, S. H., & Yas, I. W. (2016). Assessment of nurses knowledge about therapeutic communication in psychiatric teaching hospitals at Baghdad City. Kufa journal for nursing sciences, 6(2), 1-7.
Sherko, E., Sotiri, E., & Lika, E. (2013). Therapeutic communication. JAHR, 4(7), 457-466.
Stuart, G. W. (2014). Principles and practice of psychiatric nursing-e-book. Elsevier Health Sciences.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Webster, D. (2014). Using standardized patients to teach therapeutic communication in psychiatric nursing. Clinical Simulation in Nursing, 10(2), e81-e86.
As you are aware, communication is required to effectively receive and provide information. Therapeutic communication, both verbal and nonverbal, are techniques you will use in any health care entity to assess your patients, educate patients and families, and communicate among the interdisciplinary team.
This assignment is a 1-2-page paper designed to allow you to research all areas of communication that you will use, be exposed to, or need to be aware of as a health care provider. Choose an article from your research that is relevant to any type of communication used in health care. Please see the examples below.
This assignment is expected to adhere to the rubric provided, to demonstrate professionalism and critical thinking, and to use correct grammar, spelling, and format citation.
Have fun and be creative when selecting your article/communication technique to broaden your current knowledge base.
Therapeutic Communication Examples
Patients with debilitating medical conditions
Patients who are mentally ill
With patients who have hearing loss
Regarding the pediatric population
With the elderly population
Working with the multidisciplinary team
Do’s and don’ts in writing, digitally, and verbally Therapeutic listening
Communication about grief
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