6 THERAPEUTICCOMMUNICATION 129
on an ongoing basis. When the nurse examines his or
her personal beliefs, attitudes, and values as they re-
late to communication, he or she is gaining awareness
of the factors influencing communication. Gaining
awareness of how one communicates is the first step
toward improving communication.
The nurse will experience many different emo-
tional reactions to clients such as sadness, anger,
frustration, and discomfort. The nurse must reflect
on these experiences to determine how emotional re-
sponses affect both verbal and nonverbal communi-
cation. When working with clients from different cul-
tural or ethnic backgrounds, the nurse needs to know
or find out what communication styles are comfort-
able for the client in terms of eye contact, touch, prox-
imity, and so forth. The nurse can then adapt his or
her communication style in ways that will be benefi-
cial to the nurse–client relationship.
Points to Consider When Working on
Therapeutic Communication Skills
- Remember that nonverbal communication is
just as important as the words you speak.
Be mindful of your facial expression, body
posture, and other nonverbal aspects of
communication as you work with clients. - Ask colleagues for feedback about your
communication style. Ask them how they
communicate with clients in difficult or
uncomfortable situations. - Examine your communication by asking
questions such as, “How do I relate to men?
to women? to authority figures? to elderly
persons? to people from cultures different
than my own?” “What types of clients or situ-
ations make me uncomfortable? sad? angry?
frustrated?” Use these self-assessment data
to improve your communication skills.
➤ KEY POINTS
- Communication is the process people use to
exchange information through verbal and
nonverbal messages. It is composed of both
the literal words or content and all the non-
verbal messages (process), including body
language, eye contact, facial expression, tone
of voice, rate of speech, context, and hesita-
tions that accompany the words. To commu-
nicate effectively, the nurse must be skilled
in the analysis of both content and process. - Therapeutic communication is an inter-
personal interaction between the nurse and
client during which the nurse focuses on the
needs of the client to promote an effective
exchange of information between the nurse
and client. - Goals of therapeutic communication include
establishing rapport, actively listening, gain-
ing the client’s perspective; exploring client’s
thoughts and feelings, and guiding the client
in problem-solving. - The crucial components of therapeutic
communication are confidentiality, privacy,
respect for boundaries, self-disclosure, use
of touch, and active listening and observation
skills. - Proxemics are concerned with the distance
zones between people when they communi-
cate: intimate, personal, social, and public. - Active listening involves refraining from
other internal mental activities and
concentrating exclusively on what the client
is saying. - Verbal messages need to be clear and
concrete rather than vague and abstract.
Abstract messages requiring the client to
make assumptions can be misleading and
confusing. The nurse needs to clarify any
areas of confusion so that he or she does not
I NTERNET R ESOURCES
Resource Internet Address
◗Therapeutic games and activities http:// home.att.net/~recroom
◗Psychology of listening and communicating http:// http://www.allaboutcounseling.com/listening.htm
◗Team communication http:// http://www.yorkteam.com/teamc.htm