2. ICBS 120 THERAPEUTIC COMMUNICATIONS

3. Why is Communication in Healthcare Important? 1. It is something we do every day as healthcare professionals. healthcare professionals. 2. It serves as the foundation for all patient care. patient care. 3. Patient’s can read how we communicate both verbally and communicate both verbally and through our body language. through our body language.

4. Therapeutic Communication  Introduces an element of empathy.  Imparts a feeling of comfort.  Patient feels valued and respected.  Is the FOUNDATION of all patient care.  When communicating with a patient, it is important to speak with them in terms they understand.  Be aware of cultural influences.

5. Biases and Prejudices  Affect the types of communication possible; attitudes may become hostile.  Bias:  Slant toward a particular belief  Prejudice:  Defined as an opinion/judgement that is formed before all facts are known.

6. Common Biases and Prejudices 1. A preference for Western style medicine. 2. Choosing a physician according to gender. 3. Prejudice related to a person’s sexual preference. 4. Discrimination based on race or religion. 5. Hostile attitudes toward people with different values. 6. Those who cannot afford healthcare should receive less or no treatment.

7. The Communication Cycle Includes four basic elements: 1. The sender 2. Message and mode of message 3. The receiver (decode or interpret) 4. Feedback Sender Message ReceiverFeedback

8. Listening Skills  A vital part of feedback in the communication cycle.  Active listening: –Be aware of what patient is saying and NOT saying. –Make certain you heard their message correctly.

9. Verbal Communications Takes place when a message is spoken. The Five C’s of Communication: 1. Complete 2. Clear 3. Concise 4. Courteous 5. Cohesive

10. Nonverbal Communication  Body Language: unconscious movements of the body, gestures, and facial expressions.  Kinesics: study of body language. –70% of communication is nonverbal –23% is based on tone of voice –7% is actually spoken words

11. Language  Facial Expression  Territoriality/personal space: distance we feel comfortable with others while communicating.  Posture: manner in which we carry ourselves.  Position: physical stance of two individuals while communicating.  Touch

12. Congruency in Communication  Verbal and nonverbal messages must agree.  Clustering: grouping of nonverbal messages into statements or conclusions.  Masking: attempt to concreal or repress true feeling or message.  Perception: conscious awareness of one’s own feelings and the feelings of others.

13. Maslow’s Hierarchy of Needs  Abraham Maslow is the founder of humanistic psychology  According to the Hierarchy, each level of need must be satisfied before one can move to the next level.  Hierarchy facilitates therapeutic communications

14. Self- Actualization Prestige & Prestige & Esteem needs Esteem needs Belongingness and Love Needs Safety Needs Survival or Physiological Needs

15. Hierarchy of Needs Cont’d Level 1=physiologic (food, water, air) Level 2=safety and security (security, stability, and protection) stability, and protection) Level 3=belonging and love (giving and receiving of affection) and receiving of affection) Level 4=prestige and esteem (stable, healthy self-respect for ourselves healthy self-respect for ourselves and each other. and each other. Level 5=self-actualization (at peak, doing what truly fits us in life) what truly fits us in life)

16. Defense Mechanisms Behavior that is used to protect ego Behavior that is used to protect ego from guilt, anxiety, or loss of esteem. from guilt, anxiety, or loss of esteem.  Regression: attempt to withdraw from unpleasant circumstance by retreating to an earlier, more secure stage of life.  Denial: is refusal to accept painful information that is readily apparent to others.

17. Defense Mechanisms cont’d  Repression: similar to denial (unconscious)  Projection: attributing unacceptable desires, impulses, and thoughts falsely to others to avoid acknowledging they are actually the person’s own experiences (sign of mental illness)  Sublimation: channeling of a socially unacceptable behavior into an acceptable behavior.

18. Defense Mechanisms cont’d  Displacement: unconscious transfer of unacceptable emotions, thoughts, or feelings from one’s self to a more acceptable external substitute.  Compensation: conscious or unconscious over- emphasizing of a characteristic to offset a real or imagined deficiency.  Rationalization: the mind’s way of making unacceptable behavior or events acceptable by devising a rational reason.  Undoing: actions designed to make amends or cancel out inappropriate behavior.

19. Interview Techniques Knowing how to encourage the best communication between YOU and the patient.  Closed questions – can be answered with a simple yes/no. answered with a simple yes/no.  Open-ended questions – encourage the patient to verbalize more than just yes/no.  Indirect Statements – elicit a response from patient without patient feeling questioned.