Therapeutic and Non-therapeutic Communication Skills

Question 1

What is therapeutic communication?

Answer 1

Includes verbal and nonverbal techniques that focus the caregiver’s needs and advance the promotion of healing and change.

Question 2

T/F: Therapeutic comm. is judgemental.

Answer 2

False! It is nonjudgemental, discourages defensiveness, and promotes trust enhancing the nurse-client relationship.

Question 3

List 19 forms of THERAPEUTIC comm:

Answer 3

1) Silence
2) Offering self
3) Giving recognition
4) Broad openings
5) Offering general leads
6) Placing the event in time or sequence
7) Making observations
8) Encouragement
9) Presenting reality
10) Translate words to feelings
11) Accepting
12) Encouraging comparison
13) Restating
14) Reflecting
15) Exploring
16) Seeking clarification and validation
17) Voicing doubt
18) Verbalizing the implied
19) Formulating a plan of action

Question 4

Allows the nurse to slow the pace of the conversation and gives the patient the opportunity to reflect upon feelings.

Answer 4

Silence

Question 5

Making oneself available on an unconditional basis, increasing client’s feelings of self-worth.

Answer 5

Offering self

“I’ll stay with you awhile.”

Question 6

Acknowledge and indicate awareness; better than complimenting which reflects the nurse’s judgement.

Answer 6

Giving recognition

“I notice you made your bed today.”

Question 7

Allows the patient to introduce the topic; emphasizes the importance of the patient’s role in the interaction.

Answer 7

Giving broad openings

“Tell me what you are thinking.”

Question 8

Offers the pt encouragement to continue.

Answer 8

Offering general leads

“Yes, go on.” (or nod head)

Question 9

Clarifies the relationship of events in time so that the nurse and client can view them in perspective.

Answer 9

Placing the event in time or sequence

“What seemed to lead up to…”

Question 10

Verbalizing what is observed or seen.

Answer 10

Making observations

“You seem upset.”

Question 11

Asking the pt to verbalize what is being perceived.

Answer 11

Encouragement

“What are the voices telling you to do?”

Question 12

When the client has a misperception of the environment, the nurse defines reality or indicates his/her perception of the situation for the client.

Answer 12

Presenting reality

“I understand the voices seem real to you, but I do not hear any voices.”

Question 13

When feelings are expressed indirectly, the nurse tries to find clues to the underlying true feelings.

Answer 13

Translate words into feelings
Client: “I’m a lost puppy.”
Nurse: “You’re feeling very lonely right now.”

Question 14

Conveys an attitude of reception and regard.

Answer 14

Accepting

“Yes, I understand what you said.” (Eye contact/nodding)

Question 15

Asking the client to compare the similarities and differences in ideas, experiences, or interpersonal relationships. This helps the client recognize life experiences that tend to recur as well as those aspects of life that are changeable.

Answer 15

Encouraging comparison

“Was this something like…?”

Question 16

Repeating the main idea of what the client has said. This lets the client know whether or not an expressed statement has been understood and gives him or her the chance to continue or to clarify if necessary.

Answer 16

Restating
Client: “I can’t take that new job. What if I can’t do it?”
Nurse: “You’re afraid you will fail in this new position.”

Question 17

Questions and feelings are referred back to the patient to help them identify feelings and expand on their remark.

Answer 17

Reflecting
“What do you think about this?”
“Let’s come up with a few options.”

Question 18

Delving further into a subject, idea, experience, relationship; helpful with patients who stay at a superficial level.

Answer 18

Exploring

“Tell me more about that particular situation.”

Question 19

Asking pt to restate, elaborate, to give examples of ideas or feelings to seek clarification of what is unclear.

Answer 19

Seeking clarification and validation

“I don’t think I understand what you are saying. Can you please explain?”

Question 20

Expressing uncertainty as to the reality of the client’s perceptions; often used with clients experiencing delusional thinking.

Answer 20

Voicing doubt

“I understand that you believe that to be true, but I see the situation differently.”

Question 21

Putting into words what the client has only implied or said indirectly; can also be used with the client who is mute or is otherwise experiencing impaired verbal communication. This clarifies that which is implicit rather than explicit.

Answer 21

Verbalizing the implied
Client: “It’s a waste of time to be here. I can’t talk to you or anyone.”
Nurse: “Are you feeling that no one understands?’

Question 22

When a client has a plan in mind for dealing with stressful situations, it may prevent stress or anger from escalating to an unmanageable level.

Answer 22

Formulating a plan of action

“If this happens again, what can you do to handle the situation more appropriately?”

Question 23

This therapeutic style can block communication. It prevents the patient from being a mutual partner in the r’ship and places the patient in a passive role.

Answer 23

Nontherapeutic communication

Question 24

What are 14 types of NONTHERAPEUTIC comm.?

Answer 24

1) Giving reassurance
2) Rejecting
3) Approving/disapproving
4) Agreeing/disagreeing
5) Giving advice
6) Probing
7) Defending
8) Requesting an explanation
9) Indicating the existence of an external source of power
10) Belittling feeling expressed
11) Making stereotyped comments
12) Using denial
13) Interpreting
14) Introducing an unrelated topic

Question 25

What is active listening?

Answer 25

Listening with eyes, ears, and body language! Shows the patient you are fully engaged in the conversation.

Question 26

The most critical communication strategy is _____ _____.

Answer 26

active listening

Question 27

What are 4 reasons why active listening is beneficial?

Answer 27

• creates a climate in which the client can communicate
• communicates acceptance and respect for the client
• enhances trust
• promotes openness and honest expression

Question 28

Define S.O.L.E.R. listening:

Answer 28

Sit quietly facing pt
Open posture
Lean forward 
Eye contact
Relax