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Must haves for therapeutic communication
- self-awareness
- Know self
- Clarify values
- Explore own feelings
- Genuineness and respect
- Empathy –feeling with the patient
- Unconditional positive regard
- Be in control of own life and emotions
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How can you tell visual, tactile, auditory type listeners?
- "I see what you're saying..."
- "I get it," "I feel that!"
- "I hear you..."
You want to identify it and then mirror it to get into the best rapport.
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What is congruence and incongruence?
- Congruence: body language and spoken words agree.
- Incongruence: body language and spoken words are incongruent.
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What is the difference between pity and sympathy?
- Sympathy: feeling badly for someone.
- Pity: an unconscious feeling of sadness for someone and being glad it wasn't you.
Both are bad for therapeutic communication.
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Various silences?
- Therapeutic: You were talking about such and such and now you're silent. What happened?
- Thoughtful: I'd love to know what you're thinking about...
- Resistive: I'm not talking to you. Hurumph.
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What is fogging?
Agreeing with the complaint (as long as it's valid) and apologizing for the inconvenience.
Don't agree with something that isn't true.
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What is a sandwich technique?
When you need to make a critique, use a positive, then the negative, followed by another positive.
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What is the DESC Script?
- Describe the situation
- Express feelings
- Specify what you want
- Consequences?
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What are some elements to psych pt problem solving interactions?
- Define problem
- When and how?
- Propose solutions or alternatives
- Pros and cons
- Select solution
- Evaluate application of solution
- Make changes
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What are some techniques that pts will use to resist
- Keeping pertinent information to self
- Symptoms get worse
- Self-devaluation
- Short lived recovery
- Intellectual talk
- Nothing on the mind
- Acting out
- Superficial talk
- Verbalizes understanding but continues destructive behavior
- Transference/Countertransference: Projecting feelings you have about one person onto another person who reminds you of the first. Transference is pt-->nurse, countertransference is nurse--> pt.
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Acceptable Roles of the Nurse in Therapeutic Communication
- Teacher
- Socializer
- Clinician
- Advocate
- Role model
- Counselor
- Therapist
- Confidant
- Friend vs. friendly- role of the nurse. Being a friend may prevent you from doing your job.
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What sorts of nursing responses are not beneficial?
- Lacks empathy
- Feels depressed after talking with patients
- Careless with contract
- Late, runs over
- Drowsy during 1:1
- Anger at patient’s lack of change
- Argues with patients
- Encourages dependency
- Helps patients in matters not related to goals
- Defends nursing interventions to others
Don't work harder than the pt is willing to work for himself, and don't do anything for the patient that he/she can do alone.
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What are some boundaries to remember when working with the mental health?
- Don’t go into patient rooms in mental health
- Clothing- dress appropriately
- Language- address with first/last name & age appropriate
- Self-disclosure- do not do
- Watch physical contact, especially with schizophrenics.
- Be mindful of time spent with patients; don't overtax them.
- Maintain professional role
- Maintain confidentiality
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What is a MSE?
See chapt. 6 in Stuart.
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