1. Therapeutic Communication
with Psychiatric Clients
Joan Operario, MS, RN

2. 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.

3. 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.

4. 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

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

6. 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), Stuart, G. W. (2009). Therapeutic nurse-patient relationship. Principles and practice of psychiatric nursing (9th ed.). St. Louis, MO: Mosby Elsevier.

7. References
Wolf, Z. A. (2001). Communicating for the first time with delusional patients. Journal of the American Psychiatric Nurses Association, 7, doi: /mpn
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),