THERAPEUTIC COMMUNICATIONS

Active Listening: being attentive to what client is saying both verbally and nonverbally. SOLER is part of active listening. Sharing Observations: conveys concern and interest to the client be taking note of their behavior (how they look, sound or act). Empathy: ability to understand and accept another person's reality, to accurately perceive feelings, and to communicate this understanding to others. Sharing Hope: communicating a sense of possibility. Sharing Humor: to bring hope and joy to the situation. Sharing Feelings/emotions: assisting clients to share feelings by making observations, acknowledging feelings, encouraging communication, giving permission to express negative feelings and modeling healthy emotional self-expression. Using Touch: hand to body contact to convey affection, emotional support, encouragement, tenderness, and personal attention. Using Silence: the therapeutic technique of silence is the deliberate lack of verbal communication for a therapeutic purpose. Providing Information: telling others what they need or want to know Clarifying: checking to see if your understanding is accurate. Focusing: used to center on key elements or concepts of a message; used to guide direction of conversation to an important area. Paraphrasing: restating another's message more briefly and in your own words; lets another know you are actively seeking understanding of what they are saying. Asking Relevant Questions: to seek information o Open-ended questions: to allow client to take the lead in the conversation and give information o Focused questions: used when more specific information is needed in an area. o Closed-ended questions: elicit a yes, no, or one word response. Most often they block communication, but can be useful when conversation gets off track. Summarizing: concise review of key aspects of the communication Self-Disclosure: sharing personal experience with another to show you understand their experience (Remember this is not intended to be "about " you)

 Confrontation: direct confrontation to help person be aware of inconsistencies in his/her feelings, attitudes, beliefs, or behaviors

Offering Self
   

making self-available and showing interest and concern. I will walk with you paying close attention to what the patient is saying by observing both verbal and non-verbal cues. Maintaining eye contact and making verbal remarks to clarify and encourage further communication. Tell me more about your son What do you want to talk about today? Planned absence of verbal remarks to allow patient and nurse to think over what is being discussed and to say more.

2. Active listening

3. Exploring
  

4. Giving broad openings 5. Silence

6. Stating the observed

verbalizing what is observed in the patient to, for validation and to encourage discussion You sound angry y asking to describe similarities and differences among feelings, behaviors, and events. y Can you tell me what makes you more comfortable, working by yourself or working as a member of a team?

7. Encouraging comparisons
 

8. Identifying themes
   

asking to identify recurring thoughts, feelings, and behaviors. When do you always feel the need to check the locks and doors? reviewing the main points of discussions and making appropriate conclusions. During this meeting, we discussed about what you will do when you feel the urge to hurt your self again and this include

9. Summarizing

10. Placing the event in time or sequence

asking for relationship among events. When do you begin to experience this ticks? Before or after you entered grade school? voicing uncertainty about the reality of patients statements, perceptions and conclusions. I find it hard to believe asking the patients to describe feelings, perceptions and views of their situations. What are these voices telling you to do? stating what is real and what is not without arguing with the patient.

11. Voicing doubt

12. Encouraging descriptions of perceptions

13. Presenting reality or confronting

 

I know you hear these voices but I do not hear them. I am Lhynnelli, your nurse, and this is a hospital and not a beach resort. asking patient to restate, elaborate, or give examples of ideas or feelings to seek clarification of what is unclear. I am not familiar with your work, can you describe it further for me. I dont think I understand what you are saying. rephrasing patients words to highlight an underlying message to clarify statements. Patient: I wont be bothering you anymore soon. Nurse: Are you thinking of killing yourself? throwing back the patients statement in a form of question helps the patient identify feelings. Patient: I think I should leave now. Nurse: Do you think you should leave now? repeating the exact words of patients to remind them of what they said and to let them know they are heard. Patient: I cant sleep. I stay awake all night. Nurse: You cant sleep at night? using neutral expressions to encourage patients to continue talking. Go on You were saying using open-ended questions to achieve relevance and depth in discussion. How did you feel when the doctor told you that you are ready for discharge soon? recognizing and acknowledging patients feelings. Its hard to begin to live alone when you have been married for more than thirty years. pursuing a topic until its meaning or importance is clear. Let us talk more about your best friend in college You were saying providing a view of the meaning or importance of something. Patient: I always take this towel wherever I go. Nurse: That towel must always be with you. asking for patients views of the meaning or importance of something. What do you think led the court to commit you here? Can you tell me the reasons you dont want to be discharged?

14. Seeking clarification

15. Verbalizing the implied

16. Reflecting
   

17. Restating

      

18. General leads

19. Asking question

20. Empathy
          

21. Focusing

22. Interpreting

23. Encouraging evaluation

24. Suggesting collaboration

offering to help patients solve problems. Perhaps you can discuss this with your children so they will know how you feel and what you want. asking patient to decide on the type of change needed. What do you think about the things you have to change in your self? probing for step by step actions that will be needed. If you decide to leave home when your husband beat you again what will you do next? asking patients to make a choice among options. Given all these choices, what would you prefer to do. asking patients to consider the pros and cons of possible options. Have you thought of the possible effects of your decision to you and your family? providing information that will help patients make better choices. Nobody deserves to be beaten and there are people who can help and places to go when you do not feel safe at home anymore.

25. Encouraging goal setting

26. Encouraging formulation of a plan of action

27. Encouraging decisions

28. Encouraging consideration of options

29. Giving information

30. Limit setting

discouraging nonproductive feelings and behaviors, and encouraging productive ones. Please stop now. If you dont, I will ask you to leave the group and go to your room. acknowledging the difficulty in changing, but pushing for action. I understand. You feel rejected when your children sent you here but if you look at this way practicing behaviors for specific situations, both the nurse and patient play particular role. Ill play your mother, tell me exactly what would you say when we meet on Sunday. asking the patient for a verbal description of what will be said or done in a particular situation. Supposing you meet these people again, how would you respond to them when they ask you to join them for a drink?.

31. Supportive confrontation

32. Role playing

33. Rehearsing

34. Feedback
 

pointing out specific behaviors and giving impressions of reactions. I see you combed your hair today. asking patients to evaluate their actions and their outcomes. What did you feel after participating in the group therapy?. giving feedback on positive behaviors. Everyone was able to give their options when we talked one by one and each of waited patiently for our turn to speak.

35. Encouraging evaluation

36. Reinforcement