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Therapeutic Communication

In Behavioral Health

DO NOT

"Listen" to the non-verbal communication

What are YOUR

non-verbals saying?

  • Eye contact -staring or avoiding eye contact

  • Facial expressions -frowning, smiling, clenching or biting lips, raising eyebrows

  • Voice -such as tone, volume, accent, inflection, pauses

  • Body movement -posture, gestures, fidgeting

  • Physiological responses -perspiring, rapid breathing, blushing

  • Appearance

Do use silence so patients can

take control of the discussion.

Do offer general leads which encourages

patients to continue.

Do make observations by verbalizing what is

observed and/or perceived.

Feedback is useful when it is

  • Focused on behavior rather than on the client

Do give broad openings and allow the patient to select topics

  • directed toward behavior that the client has the capacity to modify

Do not give reassurances. It may cause the patient to believe their feelings will be downplayed.

Do not refuse to consider the patients ideas or behaviors.

Do not offer approval or disapproval which implies judgment is being passed.

Do not give advice which implies staff know what is right for the patient

Do not probe or push for answers when

the patient does not want to

discuss a topic

  • descriptive rather than evaluative

Do make yourself available.

  • Imparts information rather than offers advice

Mental health providers must know how to gain trust and gather information from the patient, the patient's family, and patient's friends.

DO NOT

Ask "why"

implying the patient has to

defend their behaviors

Introduce an unrelated topic and take over the direction of the conversation.

Interpret the meaning of the patients experience

Therapeutic Communication

with patients and families

is an essential skill in caring for

the patients mental health.

Belittle the patients feelings

Here come the tips...

Do present reality by clarifying misconceptions the patient may be expressing.

Do verbalize the implied. Put words to what the patient has implied.

Do explore by delving further into a subject, idea experience, or relationship.

Do Reflect -Direct questions or feelings back to the patient so they may be recognized.

Encourage

Do Restate -This demonstrates you were listening. It helps the patient know whether an expressed statement has or has not been understood.

Encourage Descriptions -ask the patient to visualize what is being perceived.

Encourage Comparisons -ask the patient to compare similarities and differences in ideas, experiences, or interpersonal relationships.

Morrissey, J., Callaghan, P. (2011).

Communication Skills for Mental Health Nurse.

(1st ed.). Berkshire England: Open University Press

Therapeutic Relationships

Require

  • Rapport
  • Trust
  • Respect
  • Genuineness
  • Empathy

THEY ARE GOAL-ORIENTED AND DIRECTED AT LEARNING AND GROWTH PROMOTION.

Introduction

  • The therapeutic relationship is the foundation on which psychiatric care is established.

  • The therapeutic interpersonal relationship is the process by which nursing staff provide care for patients.

  • Therapeutic use of self is the instrument of delivery of care to patients in need of psychosocial intervention

Nursing Planet. (Sept. 2013).

Therapeutic Communication in Psychiatric Nursing.

http://nursingplanet.com/pn/therapeutic_communication.html

Retrieved from:

DO

Actively listen to your patient.

One of the most common mistake made when caring for a patients mental health is to talk too much.

When we are talking, we are not listening.

(Morrissey, Callaghan, 2011)

Facilitate active listening with

SOLER

S: sit squarely facing the client

O: observe an open posture

L: lean forward toward the patient

E: establish eye contact

R: relax

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