Therapeutic Communication - PowerPoint PPT Presentation

About This Presentation
Title:

Therapeutic Communication

Description:

Therapeutic Communication Prepared by Sally McDonald Revised by Tim Corbett Helping vs Social Relationships HELPING Care Trust Growth Purposeful/intentional Unequal ... – PowerPoint PPT presentation

Number of Views:167
Avg rating:3.0/5.0
Slides: 40
Provided by: sally179
Category:

less

Transcript and Presenter's Notes

Title: Therapeutic Communication


1
Therapeutic Communication
  • Prepared by Sally McDonald
  • Revised by Tim Corbett

2
Helping vs Social Relationships
  • HELPING
  • Care
  • Trust
  • Growth
  • Purposeful/intentional
  • Unequal sharing
  • Focus on Clients needs
  • Time limited
  • SOCIAL
  • Care
  • Trust
  • Growth
  • Spontaneous
  • Usually equal or near equal sharing
  • Focus on needs of
  • both individuals
  • Ongoing

3
Locus of Control
  • GIVING HELP
  • Feeling important
  • Feeling useful
  • Feeling powerful
  • Feeling gratified
  • Feeling happy
  • NEEDING HELP
  • Feeling unimportant or inadequate
  • Feeling useless or depressed
  • Feeling powerless
  • Feeling frightened or embarrassed
  • Feeling sad
  • or angry

4
Phases of Helping Relationships
  • Orientation Phase
  • Working Phase
  • Termination Phase

5
Orientation Phase
  • getting to know you phase
  • setting the tone
  • making introductions
  • establishing roles
  • reaching agreement on goals
  • developing trust

6
Working Phase
  • problem solving phase
  • attending to clients needs
  • Nurse in role of teacher/counselor
  • encouraging active participation by client
  • gathering further data
  • assisting client in decision making
  • facilitating change
  • Evaluate problems goals

7
Termination Phase
  • reviewing summarizing goals met and progress
    made
  • acknowledge feelings of loss
  • reassuring clients with issues such as,
  • How will this problem/disease affect
  • my life ? or
  • What do I need to change ?

8
Communication Techniques
  • Validating/Clarifying
  • Reflecting
  • Sequencing
  • Sharing observations
  • Acknowledging feelings

9
Avoid
  • Arguing
  • Minimizing
  • Challenging
  • Giving false reassurance
  • Interpreting or speculating on the dynamics of
    the clients problems
  • Selling client on accepting treatment
  • Probing sensitive areas
  • Participating in criticism of any staff member
  • Joining any attacks led by the client

10
Attentive Listening Scale
  • -THINGS TO AVOID
  • Lack of eye contact
  • Responding before the other finishes speaking
  • Finishing other peoples sentences
  • Talking so much that others cannot respond
  • Continuing to work while someone is talking to
    you
  • Repeat a point just made
  • Allow your mind to wander during a conversation

11
Active Listening
  • 3 Phases
  • restatement involves repeating or paraphrasing
    the words of the client
  • reflection is verbalizing both the content and
    the implied feelings of the clients message
  • clarification is summarizing the clients
    thoughts feelings resolving confusion

12
Active Listening
  • STOP TALKING
  • demonstrate that you want to listen
  • remove distractions
  • be patient
  • STOP TALKING

13
Assertive Communication
  • I Statements allow people to own (take
    responsibility for) their own thoughts feelings
  • assertiveness involves taking a risk

14
NONVERBAL CUES
  • professional attire
  • sit arms length away
  • relaxed but attentive posture

15
NONVERBAL CUES
  • facial expressions and tone
  • should be friendly interested
  • use direct eye contact match your eye contact
    with the patients eye contact
  • pay attention to body language of patient as well
    as your own body language

16
Interviewing Techniques
17
INTERVIEWING TECHNIQUES
  • the purpose of the interview is to obtain
    accurate thorough information
  • put your client at ease as they may feel
    uncomfortable about revealing sensitive
    information to you
  • explaining your format helps clients accept
    understand the purpose of the interview

18
INTERVIEWING TECHNIQUES
  • in general, use open-ended questions
  • however, to obtain specific information,
    closed-ended questions are preferable
  • validate information
  • clarify responses
  • use reflective questions/comments
  • paraphrasing

19
Progression ofthe Interview
  • Broad Openings- such as
  • Tell me about yourself are designed to allow
    the client to relate his or her story in a way
    that is comfortable

20
Progression ofthe Interview
  • Open-Ended Questions
  • encourage the client to elaborate or give
    explanations (for example,
  • What happened yesterday?)
  • they provide direction keep the conversation
    focused

21
Progression ofthe Interview
  • Closed-Ended Questions
  • can be answered with 1-2 words and can be
    useful in obtaining specific types of
    information, such as
  • What is todays date?

22
EFFECTIVE INTERVIEWING
  • as a professional nurse, you will spend about
    half of your time obtaining information from
    clients colleagues
  • excellent communication as well as interviewing
    skills are fundamental, yet require years of
    practice

23
WHY, WHAT, HOW
  • why do you need the information?
  • how will the information I am seeking direct me
    in helping my client?
  • how will you phrase your questions?

24
Who to Ask?
  • if the client is able to speak, ask him/her
  • family perspectives may also be important
  • written consent may be required to question
    concurrent/previous healthcare providers
  • be courteous and respectful
  • never forget client confidentiality

25
Why Questions
  • offensive misuse of why appears threatening and
    confrontational and puts clients on the defensive
  • they can interfere with developing a therapeutic
    relationship are seldom considered therapeutic

26
ConveyingUpsetting Information
  • The SPIKES Model developed by Radziewicz Baile
    (2001)
  • Setting
  • Perception
  • Invitation
  • Knowledge emotions
  • Summary

27
Setting
  • private comfortable
  • invite others, such as family members

28
Perception
  • refers to what client and others already know
    useful in uncovering misinformation

29
Invitation
  • For example, the statement,
  • Would you like me to explain more
  • about what happened?

30
Knowledge
  • gradually dispense information assessing clients
    ability to cope with it
  • The family may insist that the client not be told
    difficult news

31
Emotions
  • let client vent while you remain calm
  • keep in mind Stages of Grief Loss
  • may need to set limits on inappropriate /harmful
    behavior

32
Summary
  • review all important information with the client
    and family
  • may need to repeat information more than once

33
AVOID
  • clichés
  • poor listening
  • closed questions
  • intimidating how/why questions
  • obvious probing questions
  • advice
  • leading questions (that suggest the response
  • that you want)
  • judgmental comments
  • diverting
  • false assurance

34
COMMON ERRORS
35
Blocks to Communication
  • Failure to respect client
  • Failure to listen
  • Minimizing feelings
  • Inappropriate comments questions
  • Excessive questions
  • Clichés
  • Yes/no questions
  • Probing
  • Changing the subject
  • Leading questions
  • Advice
  • Judgments
  • False reassurance
  • Giving approval/disapproval

36
Self-Disclosure
  • Use self disclosure to help clients open up
  • to you not to meet your own needs
  • Keep disclosures brief
  • Dont imply that your experience is exactly the
    same as the clients
  • Only self-disclose about situations that you have
    mastered

37
Self-Disclosure
  • Monitor your own comfort with
  • self-disclosure
  • Respect your clients needs for privacy
  • Remember that there are cultural variations in
    the amount of self-disclosure considered
    appropriate
  • Identify risks and benefits of self disclosure

38
Therapeutic VersusNontherapeutic Communication
  • THERAPEUTIC
  • - Facilitates transformation of working
    nurse-patient relationship
  • - Relationship allows for adequate accurate
    data collection assessment
  • - Performed with not for patient

39
Therapeutic VersusNontherapeutic Communication
  • NONTHERAPEUTIC
  • - Hinders relationship formation
  • - Prevents patient from becoming mutual partner
    relegates him/her to passive recipient of care
Write a Comment
User Comments (0)
About PowerShow.com