W2 Communication and the therapeutic relationship

Question 1

What is the therapeutic relationship?

Answer 1

A professional alliance in which the nurse joins with the client for a defined period of time to achieve health-related goals.

Definition by Arnold and Boggs (2015, p.536)

Question 2

What are the aims of the therapeutic relationship?

Answer 2

• Facilitate communication of distressing thoughts and feelings
• Assist the client with problem solving
• Help clients examine self-defeating behaviours
• Promote self-care and independence

These aims include the perspectives of the carer.

Question 3

Who is considered the founder of mental health nursing theory and practice?

Answer 3

Hildegard E. Peplau

Peplau’s first book was published in 1952.

Question 4

What are the three phases of working with patients according to Peplau?

Answer 4

• Orientation phase
• Working phase
• Termination phase

Each phase has distinct focuses and objectives.

Question 5

What is the focus of the orientation phase in Peplau’s model?

Answer 5

Identifying oneself, purpose, nature, and time available for the patient while gathering essential information.

This phase is about getting to know the patient as a person.

Question 6

What occurs during the working phase of Peplau’s model?

Answer 6

Focus on the patient’s reactions to their situation while providing information and assistance.

Health teaching and/or counselling occurs in this phase.

Question 7

What is the purpose of the termination phase in Peplau’s model?

Answer 7

Summarising and providing closure of the interaction, including care or discharge plans.

This phase requires reflection by the nurse.

Question 8

What are the core conditions of client-centred therapy developed by Carl Rogers?

Answer 8

• Empathy
• Congruence
• Unconditional positive regard

These conditions are essential for effective therapeutic relationships.

Question 9

How is empathy defined in the context of therapeutic relationships?

Answer 9

An ongoing process whereby one person strives to understand another person’s inner world and demonstrates that understanding.

Important for building relationships.

Question 10

What does congruence involve in therapeutic relationships?

Answer 10

Being genuine, authentic, and transparent in interactions.

It includes consistency between what is said and how one acts.

Question 11

What is unconditional positive regard?

Answer 11

Accepting and supporting the consumer no matter what they say or do.

It involves assuming the person is doing the best they can.

Question 12

What is self-awareness in the context of therapeutic relationships?

Answer 12

The nurse’s ability to have a clear and accurate understanding of their own thoughts, feelings, values, biases, and reactions.

It influences interactions with consumers.

Question 13

What are some key techniques for establishing a therapeutic relationship?

Answer 13

• Build trust
• Mutual assessment
• The initial interview

These techniques help in building the therapeutic alliance.

Question 14

What are counselling micro-skills?

Answer 14

Specific abilities and techniques used to facilitate effective communication and help people explore and address their concerns.

Essential for establishing rapport and promoting positive outcomes.

Question 15

List some counselling micro-skills essential for nursing and midwifery practice.

Answer 15

• Joining and listening
• Reflection of content and feelings
• Summarising
• Questions
• Use of language
• Challenging
• Instructions

These skills are the building blocks of the counselling process.

Question 16

What are some elements of clinical communication skills based on the Calgary-Cambridge guide?

Answer 16

• Identifying problems the patient wishes to address
• Using easily understood language
• Providing support
• Structuring the interview logically
• Checking the patient’s understanding

These skills enhance the therapeutic interaction.

Question 17

True or False: The therapeutic relationship is solely about the nurse’s knowledge and expertise.

Answer 17

False

It focuses on the consumer’s needs and fosters a collaborative environment.

Question 18

Fill in the blank: The therapeutic relationship is considered _______ because it serves as an intervention.

Answer 18

[curative]

It provides the context for all nursing actions.

Question 19

What are the objectives of using counselling skills?

Answer 19

To build rapport, attend and listen, explore thoughts and narratives, facilitate emotion, and learn about the person

Question 20

What are the key counselling micro skills?

Answer 20

• Joining and listening
• Reflection of content and feelings
• Summarising
• Questions
• Use of language

Question 21

Define ‘joining’ in counselling.

Answer 21

Joining is the process of connecting with the client to facilitate communication

Question 22

What is the difference between attending and listening?

Answer 22

• Attending: Physically paying attention
• Listening: Capturing and understanding the messages

Question 23

What are some nonverbal cues in attending?

Answer 23

• Eye contact
• Facial expression
• Head nod
• Body posture
• Space
• Touch

Question 24

What is reflection of content and feelings?

Answer 24

A skill that allows the patient to hear themselves think by repeating or paraphrasing their statements and identifying feelings

Question 25

What are some examples of restatement stems?

Answer 25

* Sounds like... * You’re saying that... * It feels like... * It seems that...

Question 26

What is 'parroting' in counselling?

Answer 26

Repeating word for word what the consumer has said to make them feel valued and heard

Question 27

True or False: The importance of feelings can be rated on a scale of 0-10.

Answer 27

True

Question 28

What is the balloon metaphor in counselling?

Question 29

What is the most useful micro skill in counselling?

Answer 29

Reflection of feelings

Question 30

How can a counsellor reflect feelings?

Answer 30

* Recognize the difference between thoughts and feelings * Use feeling words and metaphors * Prepare for response

Question 31

What types of questions should be avoided in counselling?

Answer 31

Interrogative questions that make the client feel uncomfortable

Question 32

What are the types of open questions in counselling?

Answer 32

* Circular questions * Transitional questions * Choice questions * Guru questions * Miracle questions

Question 33

What is a key consideration when using language in counselling?

Answer 33

Use similar language to the person seeking help

Question 34

What is a suggested process for challenging in counselling?

Answer 34

* Summarise * State your own feelings * Make a concrete statement

Question 35

What should a counsellor do when the need for intervention has been identified?

Answer 35

* Explain to the patient how to do it * Check if they want to engage * Be directive and clear

Question 36

What are the differences between closed and open questions?

Answer 36

* Closed questions lead to specific answers * Open questions encourage free dialogue

Question 37

What is the risk of turning an open question into a closed question?

Answer 37

It may limit the response to a single word instead of eliciting a detailed answer

Question 38

What is the definition of the therapeutic relationship according to Arnold and Boggs (2015)?

Answer 38

"A professional alliance in which the nurse joins with the client for a defined period of time to achieve health-related goals."

Question 39

What are the aims of the therapeutic relationship?

Answer 39

1. Facilitate communication of distressing thoughts and feelings, including the carer's perspective. 2. Assist with problem-solving and daily activities. 3. Help clients examine self-defeating behaviors and test alternatives. 4. Promote self-care and independence in collaboration with the carer.

Question 40

What are the three phases of working with patients, according to Peplau (1997)?

Answer 40

1. Orientation phase 2. Working phase 3. Termination phase

Question 41

In the orientation phase, what is the focus?

Answer 41

The focus is on getting to know the patient as a person, through listening, hearing what is said, and asking open questions.

Question 42

Which phase of Peplau's model focuses on the patient’s struggle with their situation?

Answer 42

Working phase

Question 43

What is the goal of the termination phase in Peplau's model?

Answer 43

Summarizing and providing closure, including care or discharge plans or scheduling the next interaction.

Question 44

True or False: According to Peplau, patients/consumers are passive recipients of care.

Answer 44

False

Question 45

What are the core conditions for a therapeutic relationship, according to Carl Rogers?

Answer 45

1. Empathy 2. Congruence 3. Unconditional positive regard

Question 46

Fill in the blank: Empathy is the ability to ____________.

Answer 46

"understand another person’s inner world and demonstrate that understanding."

Question 47

What is the purpose of demonstrating congruence in a therapeutic relationship?

Answer 47

To be genuine, authentic, and transparent in your interactions with the client, fostering trust.

Question 48

Which of the following is NOT a practical strategy for demonstrating congruence? A. Relating in a sincere manner B. Pretending to be an expert C. Being honest with the client about your own feelings D. Being transparent in motives and intentions

Answer 48

B. Pretending to be an expert

Question 49

True or False: Unconditional positive regard involves accepting the consumer no matter what they say or do.

Answer 49

True

Question 50

What is an important aspect of self-awareness in a therapeutic relationship?

Answer 50

It refers to the nurse’s ability to understand their own thoughts, feelings, values, biases, and reactions during interactions.

Question 51

How does self-awareness influence interactions with patients in mental health nursing?

Answer 51

It helps the nurse recognize their own biases, values, and emotional triggers, which may affect their ability to provide empathetic and non-judgmental care.

Question 52

Multiple Choice: Which of the following is a key element in building the therapeutic relationship? A. Ignoring the patient’s emotional state B. Showing empathy C. Providing only factual data D. Focusing solely on the nurse’s goals

Answer 52

B. Showing empathy

Question 53

Fill in the blank: The nurse’s self-awareness includes understanding their own ____________, which may influence how they interact with patients.

Answer 53

"values, biases, and emotional triggers"

Question 54

What does the "therapeutic alliance" refer to in nursing?

Answer 54

The collaborative and supportive relationship between the nurse and patient, which facilitates therapeutic work.

Question 55

Multiple Choice: Which of the following is NOT a technique for building a therapeutic relationship? A. Mutual assessment B. Building trust C. Ignoring the patient's feelings D. The initial interview

Answer 55

C. Ignoring the patient's feelings

Question 56

In client-centred therapy, who holds the keys to their own recovery?

Answer 56

The client/person/patient/consumer themselves.

Question 57

How does empathy improve a nurse’s ability to help patients?

Answer 57

It increases the likelihood of showing compassion and understanding the patient's feelings and experiences.

Question 58

True or False: The working phase of the therapeutic relationship includes providing comfort and reassurance, while focusing on the patient's internal struggles.

Answer 58

True

Question 59

What does unconditional positive regard involve?

Answer 59

Accepting and supporting the consumer regardless of their actions or words, and assuming the person is doing the best they can.

Question 60

Multiple Choice: Which of the following is a part of demonstrating unconditional positive regard? A. Judging the patient’s actions B) Avoiding prejudice C. Imposing your own views D. Stereotyping the patient

Answer 60

B. Avoiding prejudice

Question 61

What is the cornerstone of nursing and midwifery practice?

Answer 61

Effective communication

Question 62

Which communication skills are essential for nurses and midwives when providing care to those experiencing mental illness or distress?

Answer 62

Effective communication skills for compassionate, person-centred care and building therapeutic relationships.

Question 63

What are counselling microskills?

Answer 63

Counselling microskills are specific abilities and techniques that help facilitate effective communication and address concerns, essential for building rapport and a therapeutic alliance.

Question 64

True or False: All counselling microskills are appropriate for every situation.

Answer 64

False

Question 65

Which of the following is NOT a counselling microskill? A) Reflection of content and feelings B) Use of humor C) Summarising D) Use of language

Answer 65

B) Use of humor

Question 66

Fill in the blank: Counselling microskills are the building blocks of the ________ process.

Answer 66

Counselling

Question 67

What are the primary functions of counselling microskills?

Answer 67

Relationship building, exploring issues, resolving issues, mindfulness, and various strategies like cognitive and behavioral approaches.

Question 68

What does the Calgary-Cambridge guide focus on?

Answer 68

Rating clinical communication skills in nursing and midwifery based on effective communication principles.

Question 69

Which of the following is a key component of clinical communication according to the Calgary-Cambridge guide? A) Providing solutions for the patient B) Clarifying the patient’s prior knowledge C) Avoiding the patient’s emotions D) Keeping the interview off-track

Answer 69

B) Clarifying the patient’s prior knowledge

Question 70

True or False: When using reflection of content, you should repeat or paraphrase the exact words the patient has used.

Answer 70

True

Question 71

What is the difference between 'attending' and 'listening'?

Answer 71

Attending is physically paying attention, while listening involves capturing and understanding the messages being communicated.

Question 72

What nonverbal cues are part of 'attending'?

Answer 72

Eye contact, facial expression, head nod, body posture, and movement.

Question 73

What is an example of a 'restatement' or 'reflection of content'?

Answer 73

"You feel anxious about going on day leave tomorrow."

Question 74

What is the balloon metaphor used to explain?

Answer 74

The emotional build-up and release that can occur when emotions are expressed and managed in therapy.

Question 75

Why is it important to reflect feelings in communication?

Answer 75

It helps patients hear and understand their own emotions, creating a deeper connection and supporting emotional exploration.

Question 76

What does 'parroting' refer to in counselling microskills?

Answer 76

Repeating the consumer's words verbatim to help them feel heard and valued.

Question 77

Which of the following is an example of a closed question? A) “What kind of things do you enjoy doing?” B) “Do you feel sad today?” C) “Can you describe your feelings?”

Answer 77

B) “Do you feel sad today?”

Question 78

What type of question encourages a person to provide more details about a topic?

Answer 78

Open question

Question 79

Fill in the blank: "You’re feeling like ________." is an example of a ________ stem used in reflection of feelings.

Answer 79

"anxious"

Question 80

What is a potential danger when asking open-ended questions?

Answer 80

They can sometimes turn into closed questions if they are not carefully structured.

Question 81

What is a 'guru question'?

Answer 81

A question where the nurse or midwife offers an expert opinion or solution, often not recommended in a therapeutic setting.

Question 82

Which of the following is a challenge when using language in counselling? A) Using technical jargon B) Using metaphors C) Using simple and clear language D) Speaking too quickly

Answer 82

A) Using technical jargon

Question 83

True or False: When challenging, it is important to be gentle and sensitive.

Answer 83

True

Question 84

What should you do before giving instructions to a patient?

Answer 84

Check if they want to engage with the intervention and explain how to do it clearly.

Question 85

What does 'use of language' refer to in counselling?

Answer 85

Using similar language to the person seeking help, and employing metaphors to represent real-life experiences.

Question 86

What type of questions should be avoided in clinical communication?

Answer 86

Interrogative or accusatory questions that feel like an interrogation.

Question 87

Multiple Choice: Which microskill involves repeating or paraphrasing the content of what a patient says? A) Reflection of content B) Summarising C) Joining and listening D) Challenging

Answer 87

A) Reflection of content

Question 88

How should a nurse use reflection of feelings in their practice?

Answer 88

By gently repeating or rephrasing the patient's feelings, including inferred feelings from non-verbal cues, to help the patient process their emotions.

Question 89

What is a therapeutic relationship in nursing?

Answer 89

A professional, goal-directed relationship between a nurse and a patient built on trust, respect, empathy, and effective communication.

Question 90

Why is a therapeutic relationship important in nursing?

Answer 90

It creates a safe and supportive environment for patients, leading to better health outcomes, enhanced patient satisfaction, adherence to treatment, and overall well-being.

Question 91

What are some non-verbal ways to show you are listening?

Answer 91

* Maintain eye contact * Nod occasionally * Use facial expressions that show understanding * Lean slightly forward * Use appropriate gestures * Match the person’s pace of conversation

Question 92

What is an open question?

Answer 92

A question that encourages a detailed response and allows the patient to express themselves freely.

Question 93

What is a closed question?

Answer 93

A question that requires a brief, specific answer, often 'yes' or 'no.'

Question 94

What is a probe in communication?

Answer 94

A follow-up question that encourages further explanation or clarification.

Question 95

What is reflection of content?

Answer 95

Repeating or summarizing what the person has said to confirm understanding.

Question 96

What is reflection of feelings?

Answer 96

Identifying and verbalizing the emotions behind the words.

Question 97

What is parroting?

Answer 97

Repeating a person’s words back to them exactly as they said them.

Question 98

Fill in the blank: A therapeutic relationship is built on _______.

Answer 98

[trust, respect, empathy, and effective communication]

Question 99

True or False: Closed questions encourage detailed responses.

Answer 99

False