Therapeutic Vs Non Therapeutic Communication

SEVILLA, JOSHUA JIREH T.
BSN1-A
VERBAL TECHNIQUES FOR ENCOURAGING AND ENHANCING COMMUNICATION
TECHNIQUE EXAMPLES RATIONALE

Using open- “What are some of your biggest concerns  Gives the patient the opportunity to share
ended “ freshly on a subject
question or “ Tell me more about your general health  Avoids interjection of feelings or
comments status” assumptions by the HCP.
“ Share some of the feelings  Provides for a patient elaboration on
important topics when the HCP wants to
collect breach of information
Using focused “Point to me exactly where your pain is  Encourages the patient to share specific
questions or radiating” data necessary for completing a thorough
comments “When did you start experiencing assessment
shortness of breath”
“What is your greatest fear?”  Asks the patient to provide details
regarding various concern
 Focuses on the immediate needs of the
patient.
Providing “And then?”  Encourages patient to keep talking
general leads “Go on “  Demonstrates the nurse ‘s interest in the
“Tell me more”. patient’s concerns
Conveying “Yes” Acknowledges the importance of patient’s
acceptance Nodding thoughts, feelings, and concerns
“I follow what you are saying”
“Uh, huh”
Using Humor “You are really walking well this morning.  Provides encouragement
I’m going to have to run to catch up!”  May lighten heavy moments of discussion
 Used properly, allows patient to focus on
positive progress or better times and does
not change the subject of a conversation
Verbalizing the Patient: “I can’t talk to anyone about this.”  Encourages a patient to elaborate on a topic
implied Nurse: “Do you feel that others won’t of concern
understand?”  Provides an opportunity for the patient to
articulate more clearly a complicated topic
or feeling that could be easily misunderstood
Paraphrasing Patient: “I couldn’t sleep last night.”  Encourages patients to describe situations
or restating Nurse: “You had a trouble sleeping last more fully
communication night?”  Demonstrates that the nurse is listening
content
Reflecting “You were angry when your surgery was  Focuses on the patient’s identified feelings
feelings or delayed?” base on verbal or nonverbal cues
emotions “You seem excited about going home
today.”
Seeking “I don’t quite follow what you are saying.”  Encourages the patient to expand on a topic
clarification “What do you mean by your last that may be confusing or that seem
statement?” contradictory
Summarizing “There are things you are upset about:  Reduces interaction to three or four points
your family being too busy, your diet, ad identified by the nurse as being significant
being in the hospital too long.”  Allows the patient to agree or add additional
concerns
Validating “Did I understand you correctly that…?”  Allows clarification of ideas that the nurse
may have interpreted differently than
intended by the patient
NON THERAPEUTIC COMMUNICATION
ACTION EXAMPLES RATIONALE

Asking why questions  “Why do you do that”  Implies criticism
 “ Why are you feeling that way”  May make the patient defensive
“Why do you continue to smoke when it is Requires justification of action
unhealthy”
Using closed ended  “Do you feel better today?” Result in short , one-word Reponses
questions “Did you sleep well last night?”
Changing the subject  Patient: “I am having difficult time
talking with my daughter”  Avoids exploration of the topic
 HCP: “Do you have grand children?” raised by the patient
 Patient: “ I just want to die”  Demonstrate the HCP ‘s discomfort
HCP: “Did you sleep well last night”? with the topic introduce by the
patient
Giving false reassurance  “Everything will be okay”  Discounts the patient’s feeling
 “Surgery is nothing to be concerned  Cut off conversation about the
about legitimate concerns of the patient
“Don’t worry, everything will be fine  Demonstrate a need by the HCP to
“fix” something that the patient
wants to discuss
Giving advice  “If it were me, I would….”  Discourages the patient from
 “You should exercise more” finding an appropriate solution to
 “You should absolutely have a personal problem
chemotherapy to treat your breast  Tend to limit the patient’s ability
cancer if you expect to live to explore alternative solution to
issues that needs to be faced
Giving stereotype or “It’s for your own good” Discounts the patients feelings or
generalized response “Keep your chin up” opinions
“Don’t cry over spill milk” Limits further conversation on a topic
“You will be home before long” Maybe perceived as judgmental
Showing approval or “That’s good “  Limits reflection by patient

disapproval “You have no reason to be crying”  Stops further discussion on
patient’s decisions or actions
Implies a need for patient to have the
nurse’s support and approval
Showing agreement or “That’s right” Discontinues patient reflection on an
disagreement “I disagree with what you said” introduced topic
Implies a lack of value for the thoughts,
feelings, or concerns of patients.

Therapeutic Vs Non Therapeutic Communication

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SEVILLA, JOSHUA JIREH T.

TECHNIQUE EXAMPLES RATIONALE

ACTION EXAMPLES RATIONALE

Showing approval or “That’s good “  Limits reflection by patient

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