Relationship Development & Therapeutic Communication Flashcards
What is the instrument for delivery of care to clients in need of psychosocial intervention? What are the tools of psychosocial intervention?
Therapeutic use of self - The instrument of delivery of care to clients in need of psychosocial intervention is the therapeutic use of self.
Interpersonal communication - interpersonal communication techniques are the tools of psychosocial intervention.
Phases of a Therapeutic Nurse-Client Relationship
1) Pre-interaction Phase
- Obtain information about the client from chart, significant others, or other health team members.
- Examine one’s own feelings, fear, and anxieties about working with a particular client.
2) Orientation (introductory) phase
- Create an environment for trust and rapport.
- Establish contract for intervention
- Gather assessment data
- Identify client’s strengths and limitations
- Formulate nursing diagnoses
- Set mutually agreeable goals
- Develop a realistic plan of action
- Explore feelings of both client and nurse
3) Working phase
- Maintain trust and rapport
- Promote client’s insight and perception of reality
- Use problem-solving model to work toward achievement of
established goals
- Overcome resistance behaviors
- Continuously evaluate progress toward goal attainment
- Transference: occurs when the client unconsciously displaces or transfers to the nurse feelings formed toward a person from the past.
- Countertransference: refers to the nurses behavioral and emotional response to the client
4) Termination phase
- Progress has been made toward attainment of goals
- A plan of action for more adaptive coping with future stressful situations has been established
- Feelings about termination of the relationship are recognized and explored.
Therapeutic Communication Techniques (Define): Using silence, Accepting, and Giving recognition
Using silence: allows client to take control of the discussion, if they so desire
Accepting: conveys positive regard
Giving recognition: acknowledging, indicating awareness
Therapeutic Communication Techniques (Define): Offering self, Giving broad openings, and Offering general leads
Offering self: making oneself available
Giving broad openings: allows client to select the topic
Offering general leads: encourages client to continue
Therapeutic Communication Techniques (Define): Placing the event in time or sequence, Making observations, Encouraging description of perceptions
Placing the event in time or sequence: clarifies the relationship of events in time
Making observations: verbalizing what is observed or perceived
Encouraging description of perceptions: asking client to verbalize what is being perceived
Therapeutic Communication Techniques (Define): Encouraging comparison, Restating, and Reflecting
Encouraging comparison: Asking client to compare similarities and differences in ideas, experiences, or interpersonal relationships
Restating: lets client know whether an expressed statement as been understood
Reflecting: directs questions or feelings back to client so that they may be recognized and accepted (“sounds like you may want to ___)
Therapeutic Communication Techniques (Define): Focusing, Exploring, Seeking clarification and validation, and Presenting reality
Focusing: taking notice of a single idea or even a single word
Exploring: delving further into a subject, idea, experience, or relationship
Seeking clarification and validation: striving to explain what is vague and searching for mutual understanding
Presenting reality: clarifying misconceptions that the client may be expressing
Therapeutic Communication Techniques (Define): Voicing doubt, Verbalizing the implied, Attempting to translate words into feelings, and Formulating plan of action
Voicing doubt: Expressing uncertainty as to the reality of client’s perception
Verbalizing the implied: Putting into words what client has only implied
Attempting to translate words into feelings: Putting into words the feelings the client has expressed only indirectly
Formulating plan of action: Striving to prevent anger or anxiety escalating to unmanageable level when stressor recurs
Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Giving reassurance, Rejecting, Approving or Disapporving
Giving reassurance: May discourage client from further expression of feelings if client believes the feelings will only be downplayed or ridiculed
Rejecting: Refusing to consider client’s ideas or behavior
Approving or disapproving: Implies that the nurse has the right to pass judgement on the “goodness” or “badness” of a client’s behavior
Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Agreeing or disagreeing, Giving advice, and Probing
Agreeing or disagreeing: Implies that the nurse has the right to pass judgement on whether the client’s ideas or opinion are “right” or “wrong”
Giving advice: Implies that the nurse knows what is best for client and that client is incapable of any self-direction
Probing: Pushing for answers to issues that the client does not wish to discuss causes the client to feel used and valued only for what is shared with the nurse
Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Defending, Requesting an explanation, and Indicating the existence of an external source of power
Defending: To defend what client has criticized implies that the client has no right to express ideas, opinions, or feelings
Requesting an explanation: Asking “why” implies that the client must defend his or her behavior or feelings
Indicating the existence of an external source of power: Encourages client to project blame for his or her thoughts or behaviors on others
Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Belittling feelings expressed, Making stereotyped comments, cliches, and trite expressions, and Using denial
Belittling feelings expressed: Causes client to feel insignificant or unimportant.
Making stereotyped comments, cliches, and trite expressions: These are meaningless in a nurse-client relationship.
Using denial: Blocks discussion with client and avoids helping client identify and explore areas of difficulty.
Nontherapeutic Communication Techniques (not wrong, BUT NOT MOST THERAPEUTIC) (define): Interpreting and Introducing an unrelated topic
Interpreting: Results in the therapist telling the client the meaning of his or her experience.
Introducing an unrelated topic: Causes the nurse to take over the direction of the discussion
