Nama Mahasiswa :

NPM :

Tempat Praktik :

Waktu Praktik :

STRATEGI PELAKSANAAN KOMUNIKASI TERAPEUTIK

A. Proses
1. Deskripsi Pasien
...........................................................................................................................................................
...........................................................................................................................................................
...........................................................................................................................................................
2. Diagnosis
...........................................................................................................................................................
...........................................................................................................................................................
...........................................................................................................................................................
3. Tujuan Interaksi
...........................................................................................................................................................
...........................................................................................................................................................
...........................................................................................................................................................
4. Tindakan
...........................................................................................................................................................
...........................................................................................................................................................
...........................................................................................................................................................

B. Strategi Komunikasi dalam Pelaksanaan Tindakan

1. Fase Orientasi
a. Salam Terapeutik
.....................................................................................................................................................
 .....................................................................................................................................................
.....................................................................................................................................................
b. Evaluasi / Validasi
.....................................................................................................................................................
.....................................................................................................................................................
.....................................................................................................................................................
c. Kontrak
1) Topik
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
2) Waktu
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
3) Tempat
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
2. Fase Kerja
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
 ............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
3. Fase Terminasi
a. Evaluasi Respon Klien Terhadap Tindakan
1) Evaluasi Subjektif
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
2) Evaluasi Objektif
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
b. Rencana Tindak Lanjut
......................................................................................................................................................
......................................................................................................................................................
......................................................................................................................................................
c. Kontrak yang Akan Datang
1) Topik
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
2) Waktu
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
3) Tempat
...............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................