COMMUNICATION SKILLS

Therapeutic communication skills in

providing care to patients/clients in
health care settings
Learning Tasks
By the end of this session, students are expected to
be able to:
 Explain the importance of good relationships
with patients/clients and co workers
 Explain factors which create and maintain good
relationship with patients/clients and co workers
 Utilize the steps of creating and maintaining good
relationship with patients/clients and co workers
Therapeutic
 Of or relating to the healing of disease
 Of or relating to the medical treatment of disease or
condition
Communication
Sharing of information, ideas or attitudes between or
among people.
 Therapeutic communication is a form of
psychotherapy that uses verbal and nonverbal
techniques. Through face-to-face communication,
you are the primary focus of this type of therapy.
 "therapeutic communication" refers to the
process in which the nurse consciously influences
a client or helps the client to a better
understanding through verbal or nonverbal
communication

 Therapeutic communication helps patients to
trust and relax, while non-therapeutic
communication causes patients to feel
uncomfortable and untrusting and builds walls
barring communication between caregiver and
patient.
 A clinician will use verbal and nonverbal
techniques to assist you with finding the root
cause of a problem in a nonjudgmental way, while
showing empathy and concern
LEVELS OF THERAPEUTIC COMMUNICATION
 Therapeutic communication includes five levels:
1. interpersonal communication - Face to face
interaction between the nurse and another person.
2. transpersonal communication- interaction that
occurs within a person’s spiritual domain.
3. Small-group communication- interaction that
occurs when a small number of people meet and
share a common goal.
4. Intrapersonal communication- Powerful form of
communication that occurs within an individual.
5. Public communication- interaction with an
audience (nurses are required to use eye contact,
gestures,
Therapeutic communication
techniques
 Asking relevant questions. ask questions one at a
time, to explore the topic before going on.
 Providing information. Provide information that the
patient needs to know.
 Paraphrasing. Restating the patient’s message so
that s/he knows that the nurse is listening.
 Clarifying. assess whether the patient understood
the information.
 Focusing. Focus on key issues in the conversation.
 Summarizing. Brings a sense of closure to the
conversation.
 Self disclosing. it is a way of showing the patient
that the information is understood and shows
respect for the patient.
 Confronting. Helps the patient realize his/her
inconsistencies in feelings, attitudes, or beliefs.
Nontherapeutic communication
techniques include
 Asking personal questions.
 Giving personal opinions.
 Changing the subject tends to block further
communication.
 Automatic responses show that the nurse is not
taking the situation seriously.
 False reassurance which is not supported by facts
may do more harm than good.
 Sympathy is subjective. it prevents a clear picture
of the patient’s situation.
 Asking for explanation. Questions can cause
resentment.
 Approval or disapproval. These may send the
message that the nurse has the right to make
judgments.
 Defensive responses. The patient might feel that s/he
has no rights to an opinion.
 Passive or aggressive responses. Passive responses
avoid the issues and aggressive responses maybe
confrontational.
 Arguing. it might imply that the patient is lying or
misinformed.
Importance of good relationship with
clients/patients and co workers
 Good relationship at work place encourage
clients to express their thought and feelings more
effectively.
 Moreover its and maintains rapport within health
workers.
 Healing requires more than medicine and
treatment applications.
 In health care, human connections are essential to
the healing process and effective health care
delivery.
 The nurse becomes a ‘’skilled companion’’ on the
illness journey, encouraging, supporting and
challenging the clients as needed.
Importance of Good Relationships with
Co-workers
 Provides a unique opportunity to approach client
care from a holistic perspective by drawing on
expertise of various disciplines such as psychiatry,
medicine, dentistry, social work, nutrition,
physical and respiratory therapy.
 Caring commitment to developing constructive
working relationship with other professionals
gives directions, form and substance to all
nursing actions thereby providing a recognizable
pattern of professional nursing practice.
 Good communication among the health care
team is vital for the effective care of patients
 Co- workers can experience almost instant
kinship, because the essence of the group is the
idea that ‘’you are not alone.’’
 Co-workers can talk about their feeling and listen
to the concerns of others, knowing they all share
this experience.
Importance of Good Relationships
with Patient /Client
 Enhance client well being
 Promote recovery
 Support the self-care functioning of the client
 Patient is more satisfied with the service which
they receive
 Patient are more inclined to comply with medical
regimes and procedures, poor
 Communication is a major cause of patient
dissatisfaction.
 The desired outcome of the nurse-client
relationship is to find meaning in the illness
experience related to the specific health needs or
problems for which a client is seeking health care
interventions.
Factors for creating and maintaining
good relationship with client
 Personal and professional characteristics of the
nurse and the client
 Age, sex, appearance, diagnosis, education,
values, ethnic and cultural background
 Personality
 Expectations
 Setting
 Good communication skills
 Sincere interest in the clients welfare
Steps to Create and Maintain Good
Relationship
 Pre-interaction phase
 Introductory phase
 Working (maintaining phase) phase
 Termination phase
Pre-interaction Phase
 This is similar to the planning stage before an
interview.
 In most situations, the nurse has information
about the client before the first face-to-face
meeting.
 Such information may include the client’s name,
address, age, medical history, and social history.
Introductory Phase (Orientation)
 This is important because it sets the tone for the
rest of the relationship.
 The client and the nurse closely observe each
other and form judgments about the others
behavior.
 The three stage of this introductory phase are:
 Opening the relationship- the nurse may initially
engage in some social interaction to put the client at
ease
 Clarifying the problem- The client initially may not
see the problem clearly, the nurses major task is to
help to clarify the problem
 Structuring and formulating the contract- Nurse and
client develop a degree of trust and verbally agree
about location, frequency and length of meeting,
overall purpose of the relationship, how confidential
material will be handled, tasks to be accomplished,
duration and indications for termination of the
relationship
Working (Maintaining) Phase
 Accomplishment of the tasks outlined in the
introductory phase, enhance trust and rapport to the
nurse and client and finally develop caring process.
 The working phase has two major stages,
 Exploring and understanding thoughts and feeling- The client
explores thoughts and feelings associated with problems, develop the
skill of listening, and gains insight into personal behavior.
 Facilitating and taking action-The clients need to learn to take risk
such as to accept that either failure or success may be the outcome.
 The nurse needs to reinforce successes and help
the client recognize failures realistically
Termination phase
 Nurse and client accept feeling of loss.
 The client accepts the end of the relationship
without feelings of anxiety or dependence
Advantage of therapeutic comm
Encourages Positive Interaction
 Encouraging a patient to express himself allows
you a more succinct idea of the client's emotional
tendencies and helps determine the most
beneficial treatment approach.
 By exemplifying empathy, respect and a
nonjudgmental attitude, you promote the
favorable side of self-expression and inspire a
mutually trusting relationship.
Supports Personal Accountability
 By teaching and providing the patient with
the tools he needs to acknowledge the
challenges he’s facing and improve life
situations, you empower a client to become
more cognizant of his own behavior and self-
correct it.
Promotes Openness
 When the lines of communication are open,
patients are more likely ask for help and more
prone to be open about persisting symptoms or
difficulties they may be experiencing.
 A client's honest summation of how the therapy is
helping or impairing her allows you an
opportunity to address problematic issues
immediately and reevaluate treatment options