Mental Health N222 Week 2 (Answered)
Purpose of Therapeutic Communication
-establish rapport in the nurse/patient relationship
-demonstrate caring
-obtain crucial info about thoughts/feelings
-facilitate positive behavior changes
Communication Rules!
-focus on clients feelings right NOW
-NEVER NEVER NEVER NEVER NEVER NEVER ask WHY
Therapeutic Techniques; Offering Self
-offers presence, interest, and a desire to understand
-is NOT offered to get the person to behave in a specific way
"i would like to spend some time with you"
"i'll stay here and sit with you awhile"
Therapeutic Techniques; Making Observations
-calls attention to persons behaviors (nail biting, falling asleep, restlessness) &
encourages pt. to notice and describe thoughts and feelings
"you appear tense"
"i notice you're biting your lip"
"you appear nervous whenever John enters"
Therapeutic Techniques; Restating
-repeats main idea expressed & gives pt. idea of what's been communicated & if the
message is misunderstood, pt. can clarify
pt. "i can't sleep. i stay awake all night"
nurse "you have difficulty sleeping?"
Therapeutic Techniques; Reflecting
-directs questions, feelings & ideas back to pt. to accept their own ideas and feelings,
acknowledging pt. right to an opinion
pt. "what should i do about my husbands affair?"
nurse "what do you think you should do about it?"
Therapeutic Techniques; Focusing
-concentrates attention on a single point (useful when pt. jumps from topic to topic)
"this point you are making about leaving school seems worth looking at more closely"
Therapeutic Techniques; Exploring
-examines certain ideas & experiences more fully
"tell me more about that"
"would you describe that more fully?
"could you talk about how it was that you learned your mom was dying of cancer?"
Therapeutic Techniques; Giving Information
, -makes facts the person needs available & helps clear up fear of the unknown
"my purpose for being here is...."
"this medication is for...."
"the test will determine...."
Therapeutic Techniques; voicing doubt (specific for psychotic
hallucinatory/auditory pt.)
-undermines pt. beliefs by not reinforcing the exaggerated or false perception (this is
passive, denying their psychosis is confrontational)
"isn't that unusual?"
"really?"
"thats hard to believe"
Therapeutic Techniques; presenting reality (specific for psychotic
hallucinatory/auditory pt.)
-indicates what is real, nurse does not argue or try to convince the patient, just
describes personal perceptions
pt. "theres a huge green giraffe outside the window"
nurse "i only see a tree"
Non-Therapeutic Techniques; Givinge Premature Advice
-assumes nurse knows best & pt. can't think for themselves, inhibits problems solving &
fosters dependency
"you need to break off the relationship immediately"
instead say-
"what are the pros and cons here?"
Non-Therapeutic Techniques; Minimizing Feelings
-indicates nurse unable to understand/empathize, pt. feels belittled & insignificant
pt. "I wish I were dead"
nurse "everyone gets down in the dumps"
instead say-
"you must be feeling very upset. are you thinking of hurting yourself?"
Non-Therapeutic Techniques; False Reassurance
-underrates feelings & belittles concerns
"i wouldn't worry about that"
"you'll do just fine, you'll see"
"everything will be all right"
instead say-
"what specifically are you worried about?"
"what do you think could go wrong?
"what are you concerned might happen?
Non-Therapeutic Techniques; Asking "why" Questions
-implies criticism, often makes pt. feel defensive
"why did you stop taking your medication?"
instead say-
"tell me some of the reasons that led up to you not taking your meds"
Purpose of Therapeutic Communication
-establish rapport in the nurse/patient relationship
-demonstrate caring
-obtain crucial info about thoughts/feelings
-facilitate positive behavior changes
Communication Rules!
-focus on clients feelings right NOW
-NEVER NEVER NEVER NEVER NEVER NEVER ask WHY
Therapeutic Techniques; Offering Self
-offers presence, interest, and a desire to understand
-is NOT offered to get the person to behave in a specific way
"i would like to spend some time with you"
"i'll stay here and sit with you awhile"
Therapeutic Techniques; Making Observations
-calls attention to persons behaviors (nail biting, falling asleep, restlessness) &
encourages pt. to notice and describe thoughts and feelings
"you appear tense"
"i notice you're biting your lip"
"you appear nervous whenever John enters"
Therapeutic Techniques; Restating
-repeats main idea expressed & gives pt. idea of what's been communicated & if the
message is misunderstood, pt. can clarify
pt. "i can't sleep. i stay awake all night"
nurse "you have difficulty sleeping?"
Therapeutic Techniques; Reflecting
-directs questions, feelings & ideas back to pt. to accept their own ideas and feelings,
acknowledging pt. right to an opinion
pt. "what should i do about my husbands affair?"
nurse "what do you think you should do about it?"
Therapeutic Techniques; Focusing
-concentrates attention on a single point (useful when pt. jumps from topic to topic)
"this point you are making about leaving school seems worth looking at more closely"
Therapeutic Techniques; Exploring
-examines certain ideas & experiences more fully
"tell me more about that"
"would you describe that more fully?
"could you talk about how it was that you learned your mom was dying of cancer?"
Therapeutic Techniques; Giving Information
, -makes facts the person needs available & helps clear up fear of the unknown
"my purpose for being here is...."
"this medication is for...."
"the test will determine...."
Therapeutic Techniques; voicing doubt (specific for psychotic
hallucinatory/auditory pt.)
-undermines pt. beliefs by not reinforcing the exaggerated or false perception (this is
passive, denying their psychosis is confrontational)
"isn't that unusual?"
"really?"
"thats hard to believe"
Therapeutic Techniques; presenting reality (specific for psychotic
hallucinatory/auditory pt.)
-indicates what is real, nurse does not argue or try to convince the patient, just
describes personal perceptions
pt. "theres a huge green giraffe outside the window"
nurse "i only see a tree"
Non-Therapeutic Techniques; Givinge Premature Advice
-assumes nurse knows best & pt. can't think for themselves, inhibits problems solving &
fosters dependency
"you need to break off the relationship immediately"
instead say-
"what are the pros and cons here?"
Non-Therapeutic Techniques; Minimizing Feelings
-indicates nurse unable to understand/empathize, pt. feels belittled & insignificant
pt. "I wish I were dead"
nurse "everyone gets down in the dumps"
instead say-
"you must be feeling very upset. are you thinking of hurting yourself?"
Non-Therapeutic Techniques; False Reassurance
-underrates feelings & belittles concerns
"i wouldn't worry about that"
"you'll do just fine, you'll see"
"everything will be all right"
instead say-
"what specifically are you worried about?"
"what do you think could go wrong?
"what are you concerned might happen?
Non-Therapeutic Techniques; Asking "why" Questions
-implies criticism, often makes pt. feel defensive
"why did you stop taking your medication?"
instead say-
"tell me some of the reasons that led up to you not taking your meds"
