CORE CONCEPTS ON THERAPEUTIC • Differences between the - Validating: confirming one’s

COMMUNICATION. denotative and connotative observation.

meaning.
Communication – refers to the Example: “Are you saying that…”
reciprocal exchange of ideas between or • Incongruent communication.
- Relflecting: directing back ideas,
among persons.
Common techniques in feelings and content.
Elements of Communication: communication
Example: “You feel tense when you
• Sender – originator of To initiate conversation: fight.”
information.
- Giving broad openiong: giving the - Restating: repeating what the patient
• Message – information being patient an opportunity to set the had said.
transmitted. direction of the conversation.
- Summarizing: developing a concise
• Receiver – recipient of Example: “Is there anything that you resume of what has transpired
information. want to talk about?”
NURSE PATIENT RELATIONSHIP
• Channel – mode of - Giving recognition: focusing on the
- Series of interaction between the
communication. positive aspects of the patients
nurse and patient in which the nurse
personality.
• Feedback – return response. assist the patient to attain positive
Example: “I noticed that you combed behavioral change.
• Context – the setting of
your hair today.”
communication. CHARACTERISTICS
To establish rapport and build trust
Criteria of successful • It is goal directed, focused on the
communication: - Giving information: responding with needs of the patient, planned,
the needed facts. time limited and professional.
• Feedback
- Use of silence: refraining from sppech BASIC ELEMENTS
• Appropriateness
to give the patient a time to sort out
Trust
• Flexibility thoughts and feelings.
Rapport
• Efficiency To gather information
Unconditional positive regard
Common problems in - Focusing: assisting a patient to
communication explore a specific topic. Setting limits

• Dysfunctional communication Example: Patient: “I can’t decide Therapeutic communication

about…”
• Double blind communication PHASES
Nurse: “Let’s talk about that.
Perhaps if we talk about it, it will help A. PRE-INTERACTION PHASE
you to decide.”
 • Begins when the nurse is
assigned to a patient.
• Phase of NPR in which the patient
is excluded as an active
participant
• Nurse feels certain degree of
anxiety
• Includes all of what the nurse
thinks and does before interacting
with the patient
D. TERMINATION PHASE
• Major task of the nurse: develop
self awareness
• Data gathering, planning for first
interaction
B. ORIENTATION PHASE
• Begins when the nurse and the
patients interacts for the first
time
• Parameters of the relationship
are laid
• Nurse begins to know about the
patient
When to Terminate?
• Major task of the nurse: develop
a mutually acceptable contract
• Determine why the patient
sought help
• Establish rapport, develop trust,
assessment
C. WORKING PHASE
• It is highly individualized
• More structured than the
orientation phase
• The longest and most productive
phase of the NPR
• Limit setting is employed
• Major task: Identification and
resolution of the patient’s
problems
• Planning and implementation
• It is a gradual weaning process
• It is a mutual agreement
• It involves feelings of anxiety
• It should be recognized in the
orientation phase
• Major task: to assist the patient
to review what he has learned
and transfer his learning to his
relationship with others
• Evaluation
• When goals have been
accomplished
• When the patient is emotionally
stable
• When the patient exhibits
greater independence
• When the patient able to cope
with anxiety separation, fear and
loss
How to Terminate?
• Gradually decreased interaction
time
• Focus on future oriented topics
• Encourage expression of feelings
• Make the necessary referral
COMMON PROBLEMS AFFECTING
COMMUNICATION
• Transference – the development
of an emotional attitude of the
patient either positive or negative
towards the nurse
• Resistance – development of
ambivalent feeling towards self-
exploration
• Counter transference –
transference as experienced by
the nurse
PRINCIPLES OF CARE IN
PSYCHIATRIC SETTINGS
• The nurse views the patient as a
Holistic human being with
interdependent and interrelated
needs
• The nurse accepts the patient as
a unique human being with
inherent value and worth exactly
as he is.
• The nurse should focus on the
patient’s behavior non-
judgmentally, while assisting the
patient to learn more adaptive
ways of coping