Therapeutic Communication with Psychiatric Clients Joan Operario, MS, RN

Therapeutic Communication “The nurses’ development of effective communication in the health care setting should begin in the nursing education program” (Zavertnik, Huff, & Munro, 2010, p. 65). basic skills needed for psychiatric nursing practice: a) effective communication b) therapeutic use of self -The classroom is a non-threatening environment, therefore it is the ideal way to teach therapeutic communication skills to students and develop their skills through role playing client’s with mental illness. -Students’ fears of a psychotic patients will be allayed through the secure environment provided by the skills lab wherein they could practice their communication skills.

Therapeutic Communication Effective communication consists of application of therapeutic communication techniques such as: Active listening Seeking clarification Exploring meanings Restating Asking open-ended questions Refrain from asking “WHY?” Frequently/Regularly check for understanding Therapeutic use of self: Awareness of self Clarification of values Exploration of feelings Serving as role model Altruism Ethics and responsibility According to Shattell and Hogan (2005): -Miscommunication is the most common flaw in the process of communication. -Miscommunication may stem from cultural diversity. -Miscommunication may arise when both parties do not share the same concepts.

Therapeutic Communication Responsive Dimensions are significant in establishing rapport, trust, and open communication with the client. Nurses must possess these qualities to establish such. These are: genuineness respect empathy concreteness Action Dimensions facilitates interpersonal relationships and identifies the obstacles to client’s progress. Nurses must implement these actions in order to assist in client’s change in behavior. These are: confrontation immediacy nurse self-disclosure emotional catharsis role playing boundaries

Therapeutic Communication Barriers that may be encountered: Resistance Transference Countertransference Boundary violations

References Shattell, M. and Hogan, B. (2005). Facilitating communication: How to truly understand what patients mean. Journal of Psychosocial Nursing & Mental Health Services, 43(10), 29-32. Stuart, G. W. (2009). Therapeutic nurse-patient relationship. Principles and practice of psychiatric nursing (9th ed.). St. Louis, MO: Mosby Elsevier.

References Wolf, Z. A. (2001). Communicating for the first time with delusional patients. Journal of the American Psychiatric Nurses Association, 7,155-162. doi: 10.1067/mpn.2001.118610 Zavertnik, J.E., Huff, T.A., & Munro C.L. (2010). Innovative approach to teaching communication skills to nursing students. Journal of Nursing Education, 49(2), 65-71.