Therapeutic Communication Chapter 5 Therapeutic Communication Communication is a vital component of the medical assistant profession.

Learning Objectives Define and spell key terms List, describe, and define eight parts of the communication cycle Discuss the impact of nonverbal communication on verbal communication Describe examples of nonverbal behaviors that may enhance the effectiveness of communication

Learning Objectives Demonstrate active listening through role playing Demonstrate various communication patterns through role playing—include passive, passive-aggressive, assertive, and aggressive communication patterns

Learning Objectives Define and give examples of seven defense mechanisms that impede effective communication Describe six strategies for effectively dealing with difficult people List communication tips for interacting effectively with members of eight different cultural groups

First Impressions Medical assistants work to make a positive “first impression” for patients Good communication skills “Actions speak louder than words” Nonverbal messages using body language, facial expression, and vocal inflection Communication is complex. The medical assistant must possess effective communication skills.

The Communication Cycle Referent—motivation for the communication Sender and receiver—person delivering message is sender, person receiving message is receiver Messages—content of the communication, includes verbal, nonverbal, and symbolic language The communication cycle is a process of sending and receiving information between two or more individuals.

The Communication Cycle Channels—conveying messages through visual, auditory, and tactile senses Feedback—returned by receiver reflecting understanding of message Interpersonal variables—personal biases, education, developmental level, sociocultural factors, values, beliefs, emotions, gender, health issues, roles, relationships, and prior experiences Interpersonal variables can be a roadblock to effective communication. These variables affect our interpretation of information.

The Communication Cycle Environment—the setting in which the communication occurs; factors impacting the accuracy of communication may be pain, medication effects, anxiety, and room noise The medical assistant must address environmental and patient comfort issues in order to minimize the patient’s ability to focus, listen, and understand.

Verbal Communication Spoken language Meaning may change depending on vocal pitch, vocal inflection, word emphasis, pauses, and facial expressions Medical assistants speak clearly, use a pleasant tone Medical assistants must identify if patients have any degree of hearing loss. Face forward toward the individual so the patient can see lips moving and use adequate volume.

Nonverbal Communication Medical assistants pay careful attention to body language Open body stance, smile, and pleasant expression Body space—public, social, and personal Appropriate touch Touch can be used in an emotionally therapeutic manner to convey interest, sincerity, and empathy. Examples include a warm, firm handshake; a pat on the arm; or gently assisting someone as he or she stands.

Active Listening Important part of effective communication Listen to speaker’s words and observe body language 90% listening, 10% speaking Most people overestimate their skills as listeners. Pay close attention when patients are speaking. Do not let your mind wander.

Giving Advice Medical assistants are often asked for medical advice Proceed with caution Dispense information that is accurate and within level of education at work Avoid away from work Educate patients with facts versus “giving advice.”

Communication Patterns The passive communicator The passive-aggressive communicator The aggressive communicator The assertive communicator Passive communicators come across to others as weak and submissive. Passive-aggressive communicators appear passive and then become more aggressive to get what they want. Aggressive communicators come across as angry, pushy, bossy, selfish, or insensitive. Assertive communicators come across as clear, professional, and articulate.

Communication Challenges Defense mechanisms—rationalization, compensation, regression, repression, displacement, denial, and projection Dealing with difficult people—focus on the patient, acknowledge the patient, validate the patient’s feelings, move to solution, set boundaries, and use of “I” language Rationalizing people make excuses for their behavior. Compensation is a psychological response in which a person attempts to offset feelings of inadequacy in one aspect of life by achieving success in another. Regression is when a person reverts to behavior associated with earlier development. Repression occurs when a person eliminates from conscious thought traumatic memories or painful or conflictual thoughts. Displacement is when a person expresses anger or another emotion at a person or object that is not the cause of those emotions. Denial is the refusal to acknowledge the validity or reality of something. Projection is when a person accuses others of having certain feelings, attitudes, or behaviors that he or she has.

Cultural Variables Body language and verbal communication mean different things to different groups of people Cultural norms vary from culture to culture Become familiar with the ethnic groups in your area to promote positive communication Medical assistants should familiarize themselves with cultures in their area that are different from their own to decrease the likelihood of communication mishaps.

Discussion Discuss the last time you were in a physician’s office and if your impression was favorable Identify nonverbal communication when you and your classmates are discussing this chapter Identify words that imply giving medical advice

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