Therapeutic
Communication
GROUP: 3
Dow Institute of Nursing and Midwifery
Subject: Behavioral Psychology
Faculty: Sadia Awan
Presentation Objectives
Communication Interpersonal Therapeutic Dos Nurse-Client
Foundations Models and Don'ts Boundaries
Define communication Understand transactional Learn practical do9s and Demonstrate clear
types, techniques, purposes, and mid-range interpersonal don9ts in nurse-client professional boundaries
and barriers. relationship models. therapeutic communication. respecting client dignity.
What is Communication?
Webster9s New Collegiate Dictionary defines
Communication is a process by which information is exchanged
between individuals through a common system of symbols ,signs or
behavior. A person who sends the message is called sender or encoder
and the other who receive the message is called receiver or decoder
Sender encodes; receiver decodes the message in this Effective communication requires shared understanding of
process. symbols used.
Both participants play active roles in meaning creation.
Transactional Model
of Communication
Simultaneous Mutual
Interaction Influence
Both sender and receiver Participants co-create
send and receive messages meaning through feedback
at the same time. and perception.
Five Key Components
Sender, message, channel, receiver, and feedback define the
process.
Impact of Pre-existing Conditions
Values and attitudes influence how messages are interpreted and responded to.
Positive attitudes foster cooperation; negative attitudes can cause conflict.
Environmental
Factors Affecting
Communication
Territoriality Density
The natural tendency to claim The number of people in a
personal space affects space can influence
comfort and interaction. communication quality.
Distance
Cultural differences determine preferred personal space during
interaction.
Types of Interpersonal Distances
Intimate (0 to 18 Personal (18 to Social (4 to 12 ft) Public (12+ ft)
in) 40 in) Appropriate for interactions Suitable for public speaking
Reserved for very close Used for friendly with acquaintances or or large group
relationships and private conversations with strangers. communication.
interactions. colleagues and friends.
Key Interpersonal Skills
Asser
Listen Negot
tivene Proble
Non- ing iation
ss m
Verba Skills working solvin Decisi
l Expressing
on
Verba
Understan with g
Com ding both
needs and
others to makin
l munic values working
verbal and find a g
Com ation respectfull with
nonverbal mutually
munic y builds others, to exploring
Body cues is agreeable
ation trust. identify, and
language vital. outcome.
define and analysing
Choice of conveys
solve options to
words and feelings
problems. make
tone beyond
sound
impacts words.
decisions
message
clarity.
4
3 5
2 6
1 7
Types of Communication
Verbal Communication
1
Verbal Communication: Uses spoken or written words to convey messages clearly.
Non-Verbal Communication
2
Includes body language, facial expressions, and gestures.
Communication Impact
3
70-80% of effective communication relies on non-verbal cues.
It has been estimated that :
1 Words 2 Voice 3 Body Cues
About 7% of meaning is 38% is transmitted by 55% is transmitted by body cues.
transmitted by words. paralinguistic cues such as voice.
Therapeutic communication:
It is a purposeful, interpersonal process used in healthcare to facilitate understanding and participation, leading to
improved patient outcomes.
<An interaction between two people (usually a caregiver and a care receiver)in which input from both participants
contribute to a climate of healing , growth promotion and or illness prevention"
Therapeutic communication differs from normal communication in that it introduce an element of empathy.
Primary focus
The primary purpose of therapeutic communication is to foster a trusting and supportive relationship between a healthcare
professional, like a nurse, and a patient to facilitate their well-being, both physically and emotionally.
1 Building relationships 2 Exchanging information 3 Understanding and being
understood
4 Resolving Conflicts 5 Expressing emotions and 6 Influencing and persuading
empathy others
7 Collaborating and problem solving
Therapeutic Communication Techniques
Hays and Larson in 1963 identified a number of techniques to assist the nurse in interacting more therapeutically techniques.
Using Silence Active listening
Giving Recognition Paraphrasing
Ask Open Ended Questions Summarizing
Offering self Clarification
Unconditional Positive Regard Accepting
Honesty and authenticity Reflecting
Conditions essential to Development
of a Therapeutic Relationship
1 Rapport
2 Trust
3 Genuineness
4 Empathy
5 Respect
QUESTION:
A.
"Oh, don9t worry! The doctors do this all the time."
B.
Anxious Surgical Patient Patient says: "I'm really scared "Why are you so scared? You9ll be fine."
about my surgery tomorrow. What if something goes
wrong?" What should the nurse say?
C.
"It sounds like you9re feeling really anxious. Would you like to talk
more about what's worrying you?"
D.
"Let9s just focus on staying positive, okay?"
Therapeutic Communication
Techniques
DO's AND DON'TS
Barriers to Communication :
Stereotyping Agreeing and disagreeing
Being defensive Challenging
Changing topics and subjects Unwanted reassurance
Passing judgement Giving Common advice
Model presenting Human to Human
Relationship
THE HUMAN-TO-HUMAN RELATIONSHIP MODEL. Joyce Travelbee believed that everything the nurse (as a human) said or
did with an ill person (as a human) helped to fulfill the purpose of nursing. The nurse and the patient are human beings,
relating to each other. The process is that of interaction.
The half circle at the point of original encounter indicates the possibility of and need for developing encounter into
therapeutic relationships.
As the interaction process progresses towards rapport the circle joins into one full circle, representing that the potential
for a therapeutic relationship has been attained.
Mid Range Ideas of INTERPERSONAL
RELATIONSHIPS
Mid-range theories of interpersonal relationships These theories often offer insights into how
provide frameworks for understanding specific aspects relationships develop, how individuals interact, and the
of interpersonal dynamics, focusing on particular types factors that contribute to their success or failure.
of relationships or relationship stages, rather than
general principles.
Mid-range theories of interpersonal relationships These theories often offer insights into how
provide frameworks for understanding specific aspects relationships develop, how individuals interact, and the
of interpersonal dynamics, focusing on particular types factors that contribute to their success or failure.
of relationships or relationship stages, rather than
general principles.
Peplau's theory of Interpersonal
Relationships:
Hildegard Peplau's Interpersonal Relations Theory in
Nursing focuses on the therapeutic relationship between
nurses and patients.
Metaparadiagram of Paplau theory
Person: a developing organism that tries to reduce anxiety caused by needs.
Environment : Existing forces outside the organism and in the context of culture.
Health : A word symbol that implies forward movement of personality and other ongoing human process in the
direction of creative ,constructive ,productive ,personal and community living.
Nursing : A significant therapeutic interpersonal process . It functions cooperatively with other human process that
makes health possible for individuals in communities
Phases of Interpersonal
Relationships:
1 Orientation 2 Identification
This initial phase involves meeting, getting to know This phase involves recognizing similarities and
each other, and establishing a sense of rapport. shared interests, leading to a sense of connection.
3 Working 4 Resolution
In this phase, individuals work together towards This phase involves the conclusion of the
common goals and build a deeper level of intimacy. relationship, either naturally or through a planned or
unplanned termination.
Listening to the Patient
To listen actively is to be attentive to what client is saying both verbally and non verbally.
S O L E
Sit squarely facing the Observe an open posture . Lean forward towards the Establish eye contact .
client client
Relax
Boundaries in the Nurse Client Relationship
A boundary indicates a border or a limit .It determines the extent of acceptable limits. Many types of boundary exist . Examples include the
following:
Professional
Personal boundaries
Social boundaries boundaries
Material
boundaries
Concerns regarding professional boundaries are commonly related to the following issues:
Self Disclosure : The act of revealing personal information about oneself to others, information that they would not normally know.
Therapists may share their own experiences or feelings to help clients feel more understood and validated
Gift giving : Nurses have a professional responsibility to establish and maintain appropriate boundaries in their relationship with clients. Gift-
giving can blur these boundaries, potentially leading to an unprofessional or personal dynamic.
Warning Signs
These signs indicate that professional boundaries of the nurse client relationship may be in jeopardy
Favoring one client Giving special Keeping secrets Spending free time
over others attention to one with a client with a client
client
Frequently thinking Sharing personal Receiving gifts and
abut the client when information or continue continued
away from work concerns with a contact
client /communication
with the client after
discharge
Boundaries crossings can threaten the integrity of the nurse-client relationship . Nurse must gain self awareness and insight to be able to
recognize when professional integrity is being compromised.
References
Towsened,M. C. (2020). Psychiatric Mental Health Nursing :Concepts of care in Evidenced- Based Practice (8th ed.) .F.A.
Davis Company
Epstein RM, Borrell F, Caterina M . Communication and mental health in primary care. In New Oxford Textbook of
Psychiatry(Edrs. Gelder MG, Lopez-Ibor JJ, Andreasen NC), Oxford University Press 2000.
THANK YOU.
