Ch. 7 Relationship development Flashcards Preview

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Flashcards in Ch. 7 Relationship development Deck (18):

An interaction between two people( usually a caregiver and a care receiver) in which input from both participants contributes to a climate of healing, growth promotion, and/ or illness prevention.

Therapeutic relationship


Created by Peplau
The Stranger
The Resource person
The teacher
The leader
The surrogate
The counselor

The roles of a psychiatric nurse


A nurse is at first a stranger to the client, and the client is a stranger to the nurse.

The stranger


Provides the person to specific answers to questions usually formulated with relation to a larger problem. The nurse explains, in language that the client can understand, information related to the client's healthcare.

The resource person


The nurse identifies learning needs and provides information required by the client or family to improve the health situation.

The teacher


clients often perceive nurses as symbols of other individuals. They may view the nurse as a mother, sibling, teacher, or another nurse.

The surrogate


The nurse uses interpersonal techniques to assist clients to learn to adapt to difficulties or changes in life experiences.

The counselor


The ability to use one's personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing interventions.
-Nurses must use self-awareness, self-understanding and a philosophical belief about life, death, and the overall human condition

Therapeutic use of self


-Goal oriented
-directed at learning and growth promotion;
-goals are achieved through the problem-solving process

Dynamics of therapeutic relationship


-Rapport and trust
-Respect and genuineness
-Empathy (not sympathy)
-Non-judgmental attitude
-Understanding of self and ability to separate issues of self from issues of the patient

Essential conditions to develop a therapeutic relationship


involves preparation for the first encounter with the client. (Obtaining chart info, or listening to report, the nurse develops his or her attitude based on previous experiences. The nurse needs to be aware of these preconceptions and how they may affect his or her ability to care for the client.

the pre-interaction phase


the nurse and the client become acquainted and establish trust and rapport.
- establish a contract for intervention that details expectations and responsibilities of both client and nurse
- gather assessment data
- identify client's strengths and limitations
-formulate nursing diagnoses
-setting goals that are mutually agreeable
-explore feelings

the orientation(introductory phase)


therapeutic work of the relationship is accomplished during this phase. Tasks include:
-maintaining trust and rapport
-promoting the client's insight and perception of reality
-problem solving
-overcoming resistance behaviors
-continuously evaluating progress towards goals

The working phase


Summarization of relationship growth
Client may be anxious and react with increase dependence
Finiteness of relationship discussed

termination phase


Occurs when the client unconsciously displaces or transfers feelings formed toward a person from the past.



refers to the nurse's behavioral and emotional response to the client. These could be related to unresolved issues with significant others or in response of transference on the client's part.



Self disclosure
Gift giving

therapeutic boundaries


Modify negative thoughts, feelings, and behaviors
Methods: Identify negative patterns of thinking (cognitive distortions)
-Use ABC format for recording and analyzing (Activating event, Automatic Beliefs, Consequences of beliefs)
-Reformat negative thinking

Cognitive Behavioral Theory (CBT)