Identify and describe the phases of the therapeutic relationship.
The therapeutic relationship has four phases: pre-interaction, orientation, working, and termination.
● Thepre-interaction phaseoccurs before you meet the client. In this phase you gather information about the client.
● Theorientation phasebegins when you meet the client. The goal of this phase is to establish rapport, trust, and a timeline.
● Theworking phase Use of therapeutic communication techniques. Client clarifies feelings and concerns through verbal and nonverbal communication
● Thetermination phaseis the conclusion of the relationship.
Enhancing therapeutic Communication
Listen Actevily- node
Establish trust - ex. do what you say
Be assertive - budut hodit' vo krug da okolo, and you have tobe assertive - ask direct questions, could be uncomfortable.
Restate, clarify, and validate message - summarize what they are saying, what I hear you are saying....and this is what I'll do.
Interpret body language -
Share your observations to clarify - this is what i see, is this right?
Use open-ended question - is there anything else that you need
Sumarize the conversation - through out conversation and at the end.
Qualities of nurse patient therapeutic communication
Empathy: the desire to undestand and be sensitiveto the feelings, beliefs, and situation of another person - adapt your style, tone, vocabulary, and behavior to create the bestapproach for eachclient situation.
Respect: by valuing the client and being flexible to meet the client's needs
Genuineness: chestnost', expect clients to respond truthfully.
Conreteness: espress in concrete, specific terms what you mean, the message must be constructedan delivered in a manner that is suitable for the client.
Communication: reciprocal (vzaimnii) process. If client is unable to espress his thoughts clearly, you must be willing toconfront her to request clarification. YOu must be willing to be confronted too.
focuses on improving the health of the client, whether an individual or community.
is client-centered communication directed at achieving cient goals. It is used to establish therap. relashionship
Barriers to Therapeutic Communication
Asking too many questions: - could be disrespectful
Asking "why": - suggests critisism, may become defensive and stop talking " What concerned do you have....tell me more..
Changing the subject inappropriately: - makes you unintereseted.
Failing to probe: - failing to explore issues in detail
Expressing approval or disaproval: - be mutual, we are their resourece, we can educate
Offering advice: - help clearify options, provide info about the choices
Giving false reasurance: don't say "its going to be okey"
Stereotyping: reacial, cultural, religious, are-related, gender stereotypes distort assesment. Blatant - "He is old. he won't remember" to a women, Sutble - assumming something about the patient.
Using patronizing language: ex. "you should have used a call light" or using endearing words ex. 'honey.
Vocabulary: - speak at the level of their knowledge, simple terms
Denotative and Connotative Meaning: Denotative - is a literal (dictionary) meanig of the word. Connotative - implied(podrazumivaetsa) or emotionaly meaning of the word. Denot - "hey baby" to a baby. or in conatative to a women.
Pacing of conversation: - rhythm
Intonation: - tone of voice, reflects the feeling behin the words. pitch, cadence, volume
Clearity and brevity: - words and nonverbal language send the same message using fewest words possible.
Timing and Relevance: do teaching at a good time, when they are not in pain. Convince the person that the info we are saying is relevant to them.
Crediblility of the sender: (believability) . your credibility depends on a pattern of honest and timely response to patient concerns, as well as congruence between your verbal and nonberbal communication.
Humor: can have positive or negative effect, be careful about.
Facial expression: Communicates feelings behind a message
Posture and gaint: Clue to attitude, self-concept
Personal appearance: Clue to socioeconomic status, culture, feelings
Distance: Indicates extent of familiarity
gestures: emphasize and clarify spokne words; can have different meanings