Therapeutic Communication & De-
Escalation Cheat Sheet: Phrases,
Techniques, and Situational Examples
1. Fundamentals of Therapeutic Communication
Therapeutic communication is a purposeful form of communication
used by nurses to:
• Build trust
• Facilitate understanding
• Support emotional well-being
• Promote positive behavioral change
Key Principles:
1. Patient-centered – Focus on the patient’s thoughts, feelings, and
experiences
2. Nonjudgmental – Avoid blaming, criticizing, or making
assumptions
3. Empathetic – Demonstrate understanding of the patient’s
perspective
4. Consistent & Clear – Use language appropriate to the patient’s
age and cognitive level
2. Open-Ended vs Closed-Ended Questions
, Type Purpose Examples
Encourage patient to “Can you tell me more about
Open-
express feelings, thoughts, what’s worrying you?” “How did
Ended
or experiences that situation make you feel?”
Obtain specific
Closed- “Are you feeling anxious right
information quickly,
Ended now?” “Did you sleep last night?”
yes/no answers
Tips:
• Use open-ended questions for assessment and exploring emotions
• Use closed-ended questions to clarify facts or ensure safety
3. Active Listening Techniques
Active listening builds rapport and helps patients feel heard. Techniques
include:
1. Paraphrasing – Restate what the patient says in your own words
o Patient: “I feel trapped at work.”
o Nurse: “It sounds like your job is making you feel
overwhelmed.”
2. Reflecting Feelings – Identify and verbalize the patient’s emotions
o “You seem frustrated about that situation.”
3. Clarifying – Ask for elaboration to ensure understanding
o “Can you explain what you mean when you say you feel
stuck?”
4. Summarizing – Recap the conversation to validate patient’s
concerns
, o “So far, you’ve shared that you’re anxious about work and
having trouble sleeping.”
5. Using Silence – Give the patient time to think and express
themselves
4. Verbal and Non-Verbal Communication Tips
Mode Examples / Tips
Speak calmly, use simple language, avoid medical
Verbal
jargon, avoid “why” questions
Maintain open posture, appropriate eye contact, nodding,
Non-Verbal
gestures that show attentiveness
Tone of
Calm, steady, reassuring
Voice
Personal
Maintain safe distance, respect cultural preferences
Space
Body Avoid crossing arms, leaning in aggressively, or sudden
Language movements
5. De-Escalation Techniques: Step-by-Step
When a patient becomes anxious, agitated, or aggressive, use the
following structured approach:
Step 1: Ensure Safety
• Assess the environment for potential hazards
• Keep exits accessible
• Maintain safe distance
Step 2: Remain Calm and Centered
Escalation Cheat Sheet: Phrases,
Techniques, and Situational Examples
1. Fundamentals of Therapeutic Communication
Therapeutic communication is a purposeful form of communication
used by nurses to:
• Build trust
• Facilitate understanding
• Support emotional well-being
• Promote positive behavioral change
Key Principles:
1. Patient-centered – Focus on the patient’s thoughts, feelings, and
experiences
2. Nonjudgmental – Avoid blaming, criticizing, or making
assumptions
3. Empathetic – Demonstrate understanding of the patient’s
perspective
4. Consistent & Clear – Use language appropriate to the patient’s
age and cognitive level
2. Open-Ended vs Closed-Ended Questions
, Type Purpose Examples
Encourage patient to “Can you tell me more about
Open-
express feelings, thoughts, what’s worrying you?” “How did
Ended
or experiences that situation make you feel?”
Obtain specific
Closed- “Are you feeling anxious right
information quickly,
Ended now?” “Did you sleep last night?”
yes/no answers
Tips:
• Use open-ended questions for assessment and exploring emotions
• Use closed-ended questions to clarify facts or ensure safety
3. Active Listening Techniques
Active listening builds rapport and helps patients feel heard. Techniques
include:
1. Paraphrasing – Restate what the patient says in your own words
o Patient: “I feel trapped at work.”
o Nurse: “It sounds like your job is making you feel
overwhelmed.”
2. Reflecting Feelings – Identify and verbalize the patient’s emotions
o “You seem frustrated about that situation.”
3. Clarifying – Ask for elaboration to ensure understanding
o “Can you explain what you mean when you say you feel
stuck?”
4. Summarizing – Recap the conversation to validate patient’s
concerns
, o “So far, you’ve shared that you’re anxious about work and
having trouble sleeping.”
5. Using Silence – Give the patient time to think and express
themselves
4. Verbal and Non-Verbal Communication Tips
Mode Examples / Tips
Speak calmly, use simple language, avoid medical
Verbal
jargon, avoid “why” questions
Maintain open posture, appropriate eye contact, nodding,
Non-Verbal
gestures that show attentiveness
Tone of
Calm, steady, reassuring
Voice
Personal
Maintain safe distance, respect cultural preferences
Space
Body Avoid crossing arms, leaning in aggressively, or sudden
Language movements
5. De-Escalation Techniques: Step-by-Step
When a patient becomes anxious, agitated, or aggressive, use the
following structured approach:
Step 1: Ensure Safety
• Assess the environment for potential hazards
• Keep exits accessible
• Maintain safe distance
Step 2: Remain Calm and Centered
