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Therapeutic Therapeutic Technique: Giving Recognition ..., Slides of Communication

Communication Skills: Therapeutic and Non –Therapeutic. Therapeutic. Technique: Giving Recognition. Explanation/Rationale: Acknowledging; indicating.

Typology: Slides

2022/2023

Uploaded on 03/01/2023

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Communication Skills: Therapeutic and Non –Therapeutic
Therapeutic
Technique: Giving Recognition
Explanation/Rationale: Acknowledging; indicating
awareness; better than complimenting, which reflects
the nurse’s judgment.
Examples: “Hello, Mr. J. I notice that you made a
ceramic ash tray in OT.” “I see you made your bed.”
“Good morning, Mrs. J. I notice that you are up early.”
“I see you have a new book.” ”Hello Mrs C, you are
walking better today.”
Technique: Offering self
Explanation/Rationale: Making one self available on
an unconditional basis, increasing client’s feelings of
self-worth.
Examples: “I’ll stay with you awhile.” “We can eat
together.” “I’m interested in you.” “I’ll sit with you while
you have your snack.” “I’ll walk with you.”
Technique: Giving broad openings
Explanation/Rationale: Allows the client to take the
initiative in introducing the topic; emphasizes the
importance of the client’s role in the interaction.
Examples: “What would you like to talk about today?”
“Tell me what you are thinking.” “Is there something
you would like to do today?” “What’s on your mind?”
Technique: Offering general leads
Explanation/Rationale: Offers the client
encouragement to continue.
Examples: “Yes, I see.” “Go on.” “And after that?” “You
were saying…” “Tell me about that.” “And then…”
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Communication Skills: Therapeutic and Non –Therapeutic

Therapeutic

Technique: Giving Recognition

Explanation/Rationale

: Acknowledging; indicating

awareness; better than complimenting, which reflects

the nurse’s judgment.

Examples

: “Hello, Mr. J. I notice that you made a

ceramic ash tray in OT.” “I see you made your bed.”

“Good morning, Mrs. J. I notice that you are up early.”

“I see you have a new book.” ”Hello Mrs C, you are

walking better today.”

Technique: Offering self

Explanation/Rationale

: Making one self available on

an unconditional basis, increasing client’s feelings of

self-worth.

Examples:

“I’ll stay with you awhile.” “We can eat

together.” “I’m interested in you.” “I’ll sit with you while

you have your snack.” “I’ll walk with you.”

Technique: Giving broad openings

Explanation/Rationale

: Allows the client to take the

initiative in introducing the topic; emphasizes the

importance of the client’s role in the interaction.

Examples

: “What would you like to talk about today?”

“Tell me what you are thinking.” “Is there something you would like to do today?” “What’s on your mind?”

Technique: Offering general leads

Explanation/Rationale:

Offers the client

encouragement to continue.

Examples:

“Yes, I see.” “Go on.” “And after that?” “You

were saying…” “Tell me about that.” “And then…”

Technique: Placing the event in time or sequence

Explanation/Rationale:

Clarifies the relationship of

events in time so that the nurse and client can view

them in perspective.

Examples:

“What seemed to lead up to…?” “Was this

before or after…?” “When did this happen?” “What

happened after that?”

Technique: Making observation

Explanation/Rationale:

Verbalizing what is observed

or perceived. This encourages the client to recognize

specific behaviors and compare perceptions with the

nurse.

Examples:

“You seem tense.” “I notice you are pacing

a lot.” “You seem uncomfortable when you…” “I noticed

you were…” “You appear upset...”

Technique: Encouraging description of

perceptions

Explanation/Rationale:

Asking the client to compare

similarities and differences in ideas, experiences, or

interpersonal relationships. This helps the client

recognize life experiences that tend to recur as well as

those aspects of life that are changeable.

Examples:

“Tell me what is happening now.” “Are you

hearing the voices again?” “ What do the voices seem

to be saying?” “Tell me when you feel anxious.” “Tell

me how the medications make you feel.”

Technique: Encouraging comparison

Explanation/Rationale:

Asking the client to compare

similarities and differences in ideas, experiences, or

interpersonal relationships. This helps the client

recognize life experiences that tend to recur as well as

those aspects of life that are changeable.

Examples:

“Was this something like…” “How does this

compare with the time when…” “What was your

response the last time this situation occurred?” “What

does this resemble?” “Have you had similar

experiences?”

Technique: Focusing

Explanation/Rationale:

Taking notice of a single idea

or even a single word; works especially well with a

client who is moving rapidly from on thought to

another. This technique is not therapeutic, however,with the client who is very anxious. Focusing should

not be pursued until the anxiety level has subsided. Examples:

“This point seems worth looking at more

closely. Perhaps you and I can discuss it together.” “Of

all the concerns you have mentioned, which one is

most troublesome?”

Technique: Exploring

Explanation/Rationale:

Delving further into a subject,

idea, experience, or relationship; especially helpful with

clients who tend to remain on a superficial level of

communication. However, if the client chooses not to

disclose further information, the nurse should refrain

from pushing or probing in an area that obviously

creates discomfort.

Examples:

“Please explain that situation in more

detail.” “Tell me more about that particular situation.”

“What do you mean?” “What kind of work?”

Technique: Seeking clarification and validation

Explanation/Rationale:

Striving to explain that which

is vague or incomprehensible and searching for mutual

understanding; clarifying the meaning of what has

been said facilitates and increases understanding for

both client and nurse.

Examples:

“I’m not sure that I understand. Would you

please explain?” “ Tell me if my understanding agrees with yours.” “Do I understand correctly that you said…”“Tell me if I understood correctly.” “I’m not sure I follow

what you are saying

Technique: Presenting reality

Explanation/Rationale:

When a client has a

misperception of the environment, the nurse defines

reality or indicates his or her perception of the situation

for the client.

Examples:

“I understand that the voices seem real to

you, but I do not hear any voices.” “There is no one

else in the room but you and me.” “Your mother is not

here.” “That was a car backfiring.”

Technique: Formulating a Plan of Action

Explanation/Rationale:

Having a plan in mind for

dealing with what is considered to be a stressful

situation may help the client prevent anger or anxiety

from escalating to an unmanageable level.

Examples:

“What could you do to let your anger out

harmlessly?” “Next time this comes up, what might you

do to handle it more appropriately?” “How could you

handle this differently in the future?”

Technique: Voicing doubt

Explanation/Rationale:

Expressing uncertainty as to

the reality of the client’s perception of the situation for

the client.

Examples:

“I find that hard to believe.” “That seems

rather doubtful to me.” “Really?” “Isn’t that unusual.”

Technique: Translating words into feelings

Explanation/Rationale: “Desymbolizing” what the client

has said and finding clues to the underlying true

feelings that have been expressed indirectly.

Examples: Cl: “I’m way out in the ocean.” Ns: “You

must be feeling very lonely right now.”

Cl: “I’m dead.” Ns: “Are you suggesting you feel

lifeless?”

Technique: Verbalizing the implied

Explanation/Rationale:

Putting into words what the

client has only implied or said indirectly; can also be

used with the client who is mute or is otherwise

experiencing impaired verbal communication. This

clarifies that which is implicit rather than explicit.

Examples:

Cl: “It’s a waste of time to be here. I can’t

talk to you or anyone.”

Ns: “Are you feeling that no one understands?”

Cl: (mute)

Ns: “It must have been very difficult for you when your

husband died in the fire.”

Cl: “This is a waste of time.”

Ns: “You don’t think this is beneficial?”

Nontherapeutic

Technique: Giving reassurance

Explanation/Rationale:

Indicating to the client that

there is no cause for anxiety; thereby devaluing the

client’s feelings; may discourage the client from further

expression of feelings if he or she believes they will

only be downplayed or ridiculed.

Examples:

“I wouldn’t worry about that if I were you.”

“Everything will be all right.”

Better to say: “We will work on that together.”

Technique: Rejecting

Explanation/Rationale:

Refusing to consider or

showing contempt for the client’s ideas or behavior.This may cause the client to discontinue interaction

with the nurse for fear of rejection.

Examples:

“Let’s not discuss…” “I don’t want to hear

about…” “Don’t say that.” Better to say: “Let’s look at

that a little closer.”

Technique: Approving or disapproving

Explanation/Rationale:

Sanctioning or denouncing

the client’s ideas or behavior; implies that the nurse

has the right to pass judgment on whether the client’s

ideas or behaviors are “good” or “bad”, and that the

client is expected to please the nurse. The nurse’s acceptance of the client is then seen as conditional

depending on the client’s behavior.

Examples:

“That’s right. I agree.” “That’s wrong. I

disagree.” “I don’t believe that.” Better to say: “Let’s

talk about how your behavior invoked anger in the

other clients at dinner.”

Technique: Agreeing or disagreeing

Explanation/Rationale:

Indicating accord with or

opposition to the client’s ideas or opinions; implies that

the nurse has the right to pass judgment on whether

the client’s ideas or opinions are “right” or “wrong”.

Agreement prevents the client from later modifying his

or her point of view without admitting error.

Disagreement implies inaccuracy, provoking the need

for defensiveness on the part of the client.

Examples:

“That’s right. I agree.” “That’s wrong. I

disagree.” “I don’t believe that.” Better to say: “Let’s

discuss what you feel is unfair about the new

community rules.”

Technique: Giving Advice

Explanation/Rationale:

Telling the client what to do

or how to behave implies that the nurse knows what is

best and that the client is incapable of any self-

direction. It nurtures the client in the dependent role by

discouraging independent thinking.

Examples:

“I think you should…” “Why don’t you…”

Better to say: “What do you think you should do?”

Technique: Defending

Explanation/Rationale

: Attempting to protect

someone or something from verbal attack. To defendwhat the client has criticized is to imply that he or she

has no right to express ideas, opinions, or feelings. Defending does not change the client’s feelings and

may cause the client to think the nurse is taking sides

with those being criticized and against the client.

Examples:

“This is a fine hospital.” “No one here would

lie to you.” “You have a very capable physician. I’m

sure he only has your best interests in mind.”

Better to say: “I will try to answer you questions and

clarify some issues regarding your treatment.”

Technique: Requesting an explanation

Explanation/Rationale:

Asking the client to provide

the reasons for thoughts, feelings, behavior, and

events. Asking “why” a client did something or feels a certain way can be very intimidating, and implies thatthe client must defend his or her behavior or feelings. Examples:

“Why do you think that?” “Why do you feel

this way?” “Why did you do that?” Better to say: “

Describe what you were feeling just before that

happended.”

Technique: Indicating the existence of an external

source of power

Explanation/Rationale:

Attributing the source of

thoughts, feelings, and behavior to others or to outsideinfluences. This encourages the client to project blame

for his or her thoughts or behaviors on others rather

than accepting the responsibility personally.

Examples:

“What makes you say that?” “What made

you do that?” “What made you so angry last night?” Better to say: “You became angry when your brother

insulted your wife.”

Technique: Introducing and unrelated topic

Explanation/Rationale:

Changing the subject causes

the nurse to take over the direction of the discussion.

This may occur to get to something that the nurse

wants to discuss with the client or to get away from a

topic that he or she would prefer not to discuss.

Examples:

Cl: “I don’t have anything to live for.” Ns:

“Did you have visitors this weekend?” Better

technique: The nurse must remain open and free to

hear the client and to take in all that is being

conveyed, both verbally and nonverbally.