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Friday, April 3, 2009

Using Therapeutic Communication for NLE, NCLEX & CGFNS Exams

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NurseReview.Org - Using Therapeutic Communication - Presentation Transcript

1. THERAPEUTIC COMMUNICATION communicating can be difficult and frustrating • o when clients are hallucinating, withdrawing from reality, or relatively mute o maintain nonverbal communication esp since verbal communication is not very successful o involves spending fairly lengthy periods of silence Use therapeutic communication techniques to collaborate in assessment & planning • o offer support & encouragement to client to help manage anxiety responses o validate the overwhelming feelings that client experiences while indicating the belief that the client can make needed changes & regain a sense of control o encourage client to talk about feelings & to describe in detail as the client can tolerate Use a soothing, calm voice • Keep communication simple & calm • Evaluate the use of touch • therapeutic use of self – for clients with reality orientation & verbal communication • difficulties o can demonstrate the nurse’s genuine interest and caring to the client o use of self is a contact with reality for the client calling client by name making references to the day and time commenting on the environment o clients who are left alone for long periods become more deeply involved in their psychosis, so frequent contact and time spent with client are important even if nurse is unsure that client is aware of the nurse’s presence active listening for clients with disorganized or nonsensical • o rather than dismissing the unclear statements of clients, nurse must make efforts to determine the meaning the client is trying to convey o listening for theme or recurrent statements, asking clarifying questions, and exploring meaning to client’s statements o nurse must let client know when his meaning is not clear – never pretend to understand or just to agree Nurse: “How are you feeling today?” (broad opening statement) Client: “Invisible.” Nurse: “Can you explain that to me?” (seeking clarification) Client: “Oh it doesn’t matter.” Nurse: “I’m interested in how you feel; I’m just not sure I understand.” (offering self/seeking clarification) Client: “It doesn’t mean much.” Nurse: “Let me see if I can understand. Do you feel like you’re being ignored, that no one is really listening?” (verbalizing the implied) When anxiety has subsided, as open ended communication techniques to discuss the • experience ESTABLISHING THERAPEUTIC COMMUNICATION Establishment of trust – to allay fears of a frightened client • o be patient → Initially, client can tolerate 5-10 minutes of contact at one time o provide explanations that are clear, direct and easy to understand o body language eye contact but not staring relaxed body posture
2. facial expressions that convey genuine interest and concern o telling client one’s name & calling client by name – helps in establishing trust as well as reality orientation Use of touch – assess carefully the client’s response •

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