Communication

Question 1

What is therapeutic communication?

Answer 1

Verbal and non-verbal communication between practioner/client - helps client reduce emotional distress, is supportive, educates, gives feedback, brings balance to perspectives.

Question 2

What are key areas of effective therapeutic communication?

Answer 2

• Empathy
• Trust
• Using open-ended questions
• Silences
• Self-disclosure
• Advice giving
• Reflection

Question 3

List barriers to practitioner communication:

Answer 3

• Desk in between practitioner/client
• Windows - behind or side of practitioner - have back to window
• Unpracticed verbal/non-verbal communication

Question 4

What is empathy?

Answer 4

Understanding a situation from the perspective of someone else (client). Understand the emotions of someone else.

Question 5

List 4 x techniques of effective listening:

Answer 5

1. Clarification - clarify you understand
2. Reflection - show’s interest/no judgement
3. Paraphrasing - allows disclosure/builds trust/client hears own story
4. Summarising - draws conclusions/encapsulates main ideas/issuers, outlines client perspectives

Question 6

List 6 x barriers to effective communication:

Answer 6

1. Variation of cultural norms i.e. personal space/gestures
2. Language barriers
3. Assumption of sexual orientation/gender roles i.e. do you have a girlfriend (asked to boy)
4. Gender stereotypes - problematic
5. Religion/spirituality - be impartial
6. Social class - be aware of class bias

Question 7

List 6 x barriers to effective communication:

Answer 7

1. Variation of cultural norms i.e. personal space/gestures, beliefs, values, nonverbal cues
2. Language barriers
3. Assumption of sexual orientation/gender roles i.e. do you have a girlfriend (asked to boy)
4. Gender differences/stereotypes - problematic
5. Religion/spirituality - be impartial
6. Social class - be aware of class bias
7. Role uncertainty by client
8. Sensory overload
9. Tone/pitch/volume
10. Word choice - pitch to client
11. Physical appearance - be aware of biases

Question 8

Describe optimal non-verbal behaviour by clinician:

Answer 8

Sit squarely, open
Lean towards client slightly
Smile
Use appropriate eye contact (4-5 sec duration at a time)
Relax body

Question 9

Therapeutic communication should be?

Answer 9

Professional
Patient-centred
Goal directed
Scientifically based

Question 10

Communication mistakes to avoid:

Answer 10

1. Why questions - criticism/defensive response
2. Value judgements - client feels bad/disengages
3. Minimising patient feelings - no empathy
4. False assurance - belittles patient - I know how you feel
5. Too many questions - confusion
6. Disapproving/disagreeing - defensive response
   7, Premature advice - assumption practitioner all knowing
7. Approval/agreeing - judgement (good, therefore change = bad)
8. Changing subject - disinterest

Question 11

How to communicate therapeutically:

Answer 11

• Recognition to patient
• Broad openings - anything you’d like to discuss
• Offer lead - mm, ok, go on…
• Client to suggest plan
• Client describe what they are experiencing* How does that make you feel - client to evaluate
• Paraphrasing/reflecting back/re-stating
• Suggesting collaboration

Question 12

What does communication include:

Answer 12

words
gestures
expressions
tone
body language
eye contact

Question 13

Communication is a method of passing on what?

Answer 13

Information

Meaning/context

Question 14

What are important communciation skills?

Answer 14

Open-ended enquiry
Active listening
Reflective practice
Empathy
Caring behaviours

Question 15

What are the elements of effective communication?

Answer 15

Tone, pitch volume, speed

Non-verbal communciation

Question 16

What does proxemics mean?

Answer 16

It’s the amount of personal space people need.

Question 17

Which factors affect communication?

Answer 17

Perceptions/interpretation impacted by:

• ethnic background
• level of education
• socioeconomic factors
• age
• life experience

Other factors:

• time of day
• mental health
• current life events

Question 18

What are the four levels of communication?

Answer 18

1. Intrapersonal (self)
2. Interpersonal - two people
3. Small group discussion (more than one other)
4. Organisational communication

Question 19

What is the three-step framework for active listening?

Answer 19

1. Restatement - re-state
2. Reflection - reflect back
3. Clarification - can do this, or can do that - client chooses

Question 20

Name two active listening questions:

Answer 20

1. What are the priorities?

2. What would most benefit the client?

Question 21

Where are anger, fear, and sadness seen in?

Answer 21

eyes

Question 22

Where are happiness and disgust seen?

Answer 22

mouth

Question 23

With proxemics, what are the four space zones?

Answer 23

Intimate
Personal
Social
Public

Question 24

Name the three types of touch in the clinical setting:

Answer 24

1. Procedural/instrumental - moving clinet/drawing blood
2. Expressive/caring - hand shoulder
3. Therapeutic - massage/physio work

Question 25

What are the physiological responses when catecholamines are released in response to laughter?

Answer 25

* Increased alertness * Increased problem solving * dilated blood vessels * Increased heart rate * Increased HDL (good) cholesterol * Reduced risk of heart disease * Increased O2 in lungs * Reduced CO2 in lungs * Reduced mention in muscles * Reduced stress hormones

Question 26

Name four types of conflict:

Answer 26

1. Personal conflict - internal conflict / interrole conflict 2. Interpersonal conflict - between two people or more 3. Intragroup conflict - issues between members of group 4. Intergroup conflict - issues between groups - depts/organisations

Question 27

What are 4 factors that influence conflict outcomes?

Answer 27

1. The issue 2. Cooperation by parties 3. Power position of parties 4. Communication skills of those involved

Question 28

When may conflict resolution be hard?

Answer 28

When there is a principle involved.

Question 29

List 6 x strategies used to manage conflict:

Answer 29

1. avoidance - dodge conflict/passive-positive if angry/let go minor conflicts 2. accommodation - good short-term, long-term = frustration - maintain harmony 3. competition - aggressive method red. conflict - power driven 4. compromise - 1/2 between accomm/competition 5. **collaboration** (preferred option!) - win win solutions - mutual goals, problem solving, strong relationships 6. Mediation - neutral party req. when resolution unsuccessful Evaluate conflict to decide best resolution tool.

Question 30

What are the three T's in Treatment?

Answer 30

1. Theory - scientific base 2. Technique - how to tools 3. Therapeutic alliance - apply theory/technique

Question 31

What is the purpose of a biomedical interview?

Answer 31

Identify disease/dysfunction and determine req. medical intervention (2 x F's - find it, fix it)

Question 32

Describe common steps to biomedical interviews:

Answer 32

Medical history Open-ended questions Closed-ended questions - fine-tune info rec. Doc prompts description of symptoms

Question 33

List problems with biomedical interviews:

Answer 33

* clinician interruption * diagnostic info withheld client * assumptions - 1st wave info * social history not included - just biomedical info

Question 34

What are the positive results of client-centered interviews?

Answer 34

* Positive outcomes * Gained trust * Improved adherence * Increased personal empowerment * improved client satisfaction * strong rapport client/clinician

Question 35

What is the main way clinicians learn about clients with client-centered interviews?

Answer 35

Client's storytelling

Question 36

How do you avoid 'doorknob' discussions during client-centered interviews?

Answer 36

Ask - is there anything else you'd like to discuss. | Set aside time for this.

Question 37

According to arther Kleinman, what is the explanatory model and why is it essential to client-centered interviews?

Answer 37

Belief systems used to understand an individual's health. Gives clinician insight into client perceptions of health/issues. Gives context. Q to client - what do you think is wrong?

Question 38

What is Boyle's recommended sequence for client-centered interviews?

Answer 38

Invite - I'm interested in knowing something about you - 'see' client - what brings you here today? Listen - attentive listening - process, reflect, ask open-ended questions Summarise in statements. Closed-ended questions to clarify info as req.

Question 39

With the Yale approach to communication/persuasion, what is the breakdown of communication?

Answer 39

1. Who - source (communicator) 2. What - the message 3. Whom - audience

Question 40

According to the Yale approach to communication/persuasion, what are the 4 steps to persuasion?

Answer 40

1. Attention = audience 2. Comprehension 3. Acceptance 4. Retention

Question 41

According to the Yale approach to communication/persuasion, what are factors about the communicator that increase the persuasion of the message?

Answer 41

* more greatly influenced by those we know/attracted to * If communicator is an expert - skills to persuade * Communicator holds power open to us - more influential

Question 42

Why does who the communicator is, affect the receipt of the message?

Answer 42

* more likable/similar - more open to message * if more believable - more persuasive * the closer ideas are to existing ideas, more likely to adopt * timing affects acceptance of info