Therapeutic commnication
-
Upload
balkeej-sidhu -
Category
Environment
-
view
26 -
download
1
Transcript of Therapeutic commnication
![Page 1: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/1.jpg)
PRESENTED BY:- Balkeej kaur M.Sc (N) Ist yr Roll no- 08
THERAPEUTIC COMMUNICATION
![Page 2: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/2.jpg)
The therapeutic interaction between nurse and the client will be helpful to develop mutual understanding between two individuals.
Interaction is a learning experience for both client and for the nurse , and a corrective emotional experience to the client to modify his behavior.
It establishes trusting relationship, wins the confidentiality whereby the client
It can reveal his thought and feelings openly.
INTRODUCTION
![Page 3: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/3.jpg)
“The nurse directs the communication towards the patient to identify his current problems, plans, implements and evaluates the action taken”.
(Bimla kapoor,2002)
“promotes mutual understanding, establishes a constructive relationship between the nurse and the client”.
(kozier,2004)
DEFINITION:
![Page 4: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/4.jpg)
To achieve self realization, self acceptance, self respect, personal identity.
To formulate good interpersonal therapeutic relationship.
Satisfy needs and to achieve realistic personal goals.
Permits the client to express their thoughts truly, openly.
Aids in clarification of internal conflicts and frustrations of the client
Objectives
![Page 5: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/5.jpg)
Improves client’s ego strengthsEncourage socialization and family interaction
processTreats communication problemsModifies maladaptive behavior into adaptive
behaviorMotivates the client to utilize new coping strategiesHelps the nurse to identify and intervene appropriate
nursing approaches.Assists the client to develop self control and utilizes
problem solving skills in attacking the problems.Implements nursing process effectively.
CONTI……..
![Page 6: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/6.jpg)
COMMUNICATION PROCESS
![Page 7: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/7.jpg)
![Page 8: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/8.jpg)
Intrapersonal communication
Interpersonal communication
Transpersonal communication
Small group communication
Public communication
LEVELS OF COMMUNICATION
![Page 9: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/9.jpg)
It occurs within an individual. This level of communication is also called self talk, inner thought and inner dialogue.
Intrapersonal communication
![Page 10: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/10.jpg)
It is one to one interaction between the nurse and another person that often occurs face to face. Meaningful interpersonal communication results in exchange of ideas, problem solving, expression of feelings, decision making and personal growth.
Interpersonal communication
![Page 11: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/11.jpg)
It occurs within a person’s spiritual domain. Many persons use prayer, meditation religious rituals to communicate with their higher power. Nurses who value the importance of human spirituality often use this form of communication with clients and for themselves.
Transpersonal communication
![Page 12: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/12.jpg)
It occurs when a small number of persons meet together. It is usually goal directed and requires an understanding of group dynamics. Nurses use this level of communication for group therapy.
Small group communication
![Page 13: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/13.jpg)
It is the interaction with the audience. Nurses have opportunities to speak with groups of consumers about health related topics, present scholarly work to colleagues at conferences or lead classroom discussions.
Public communication
![Page 14: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/14.jpg)
Verbal CommunicationNonverbal Communication
FORMS OF COMMUNICATION
![Page 15: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/15.jpg)
Verbal communication refers to the form of communication in which message is transmitted verbally. Objective of every communication is to have people understand
what we are trying to convey.
Verbal Communication
![Page 16: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/16.jpg)
Oral Communication: In oral communication, Spoken words are
used. It includes face-to-face conversations, speech, telephonic conversation, video, radio, television, voice over internet. In oral communication, communication is influence by pitch, volume, speed and clarity of speaking.
![Page 17: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/17.jpg)
Advantages of Oral communication:It brings quick feedback.In a face-to-face conversation, by reading
facial expression and body language one can guess whether he/she should trust what’s being said or not.
![Page 18: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/18.jpg)
Nonverbal communication is the sending or receiving of wordless messages. We can say that communication other than oral and written, such as gesture, body language, posture, tone of voice or facial expressions, is called nonverbal communication.Nonverbal communication is all about the body language of speaker.
Nonverbal Communication
![Page 19: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/19.jpg)
Nonverbal communication have the following three elements:
AppearanceSpeaker: clothing, hairstyle, neatness, use of cosmeticsSurrounding: room size, lighting, decorations, furnishings
Body Languagefacial expressions, gestures, postures
SoundsVoice Tone, Volume, Speech rate
![Page 20: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/20.jpg)
Written CommunicationIn written communication, written signs or
symbols are used to communicate. A written message may be printed or hand written. In written communication message can be transmitted via email, letter, report, memo etc.
![Page 21: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/21.jpg)
Advantages of written communication includes:Messages can be edited and revised many time before it is actually sent.Written communication provide record enables receiver to fully understand it and send appropriate feedback.
Disadvantages of written communication includes:Unlike oral communication, Written communication doesn’t bring instant feedback.It take more time in composing a written message
![Page 22: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/22.jpg)
Changing topic without listening
Offering challenges
Too much advising
Belittling the patient will reinforce with drawl features of client
CONTI……
![Page 23: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/23.jpg)
Intimate zone( 0 to 18 inches):1. Holding a crying infant2. Performing physical assessment3. Bathing, grooming, dressing, feeding a
client
Personal zone(18 inches to 4 feet):1. Sitting at client’s bedside2. Taking the client’s nursing history3. Exchanging information at change of shift
ZONES OF PERSONAL SPACE
![Page 24: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/24.jpg)
Social zone( 4 to 12 feet):1. Making rounds with physician2. Sitting at the head of the conference table3. Teaching a class4. Conducting family therapy
Public zone(12 feet and greater):1. Speaking at a community forum
![Page 25: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/25.jpg)
Pre-interaction phaseOrientation phaseWorking phaseTermination phase
PHASES OF THERAPEUTIC RELATIONSHIP
![Page 26: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/26.jpg)
PRE- INTERACTION PHASE:
It begins before the nurse’s first contact with the patient. The nurse’s initial task is one of self exploration.
![Page 27: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/27.jpg)
TASKS DURING PRE-INTERACTIVE PHASE:
Explore own feeling, fantasies and fears.
Analyze own professional strengths and limitations.
Gather data about patient whenever possible.
Plan for first meeting with the client.
![Page 28: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/28.jpg)
INTRODUCTORY OR ORIENTATION PHASE:
During this phase, the nurse sets the stage for one to one relationship by becoming acquainted with the patient. Both the nurse and the patient may experience anxiety when they first meet. The reason for seeking help forms the basis for nursing assessment and helps the nurse to focus on the patient’s problem and to determine patient motivation.
![Page 29: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/29.jpg)
TASKS DURING INTRODUCTORY PHASE:Building trust and rapport.therapeutic environment.Establishing a mode of communication
acceptable to both the patient and nurse.Initiating a therapeutic contract by establishing
a time, place and duration for each meetingAssessing the patient’s strengths and
weaknesses.To explore patient’s perceptions, thoughts,
feelings and actions.To identify patients pertinent problems.To define mutual, specific goals with the client.
![Page 30: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/30.jpg)
WORKING PHASE:The nurse and the patient explore relevant
stressors and promote the development of insight in the patient by linking perception, feelings, thoughts and actions.
The nurse helps the patient to master anxieties, increase independence and self responsibility, and develop constructive coping mechanisms.
Actual behavior change is the focus of this phase. Patient usually displays resistance during this phase. The patient begins to relax, trust the nurse.
![Page 31: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/31.jpg)
TASKS IN WORKING PHASE:Exploring perception of reality.Developing positive coping behavior.Identifying available support systems.Promoting a positive self concept.Encouraging verbalization of feelings.Developing a realistic plan of action.Implementing the plan of action.Evaluating the results of plan of action.Promoting independence.
![Page 32: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/32.jpg)
TERMINATION PHASE:It is the most difficult but most important phase
of therapeutic relationship. During the termination phase, learning is maximized for both the patient and the nurse. It is a time to exchange feelings and memories and to evaluate mutually the patient’s progress and goal attainment. sense of loss experienced by both the nurse and the patient.
![Page 33: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/33.jpg)
General ability e.g. ability to listen, interpret, speak and express through writing
Special abilities
-Process the therapeutic interaction to attain the goals -Ability to differentiate and follow when to be silent,
speak, smile, interact-Ability to wait, proceed, speed-Participates actively and maintains therapeutic nurse-
patient relationship
THERAPEUTIC COMMUNICATION SKILLS REQUIRED FOR NURSE
![Page 34: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/34.jpg)
Not listening properly
Maintaining dominance
False hopes
Too much probing in to personal matters
Making stereotyped comments
BARRIERS TO THERAPEUTIC COMMUNICATION
![Page 35: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/35.jpg)
Courtesy:The nurses say hello and goodbye as a common
courtesy. Knocks the door before entering the room, uses self introduction, addresses people by name, says thank you and please.
Use of names:Nurse’s failure to give a name indicate status or
acknowledge the client can create uncertainity about interaction and convey an impersonl lack of commitment or caring.
ELEMENTS OF PROFESSIONAL COMMUNICATION
![Page 36: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/36.jpg)
Privacy and confidentiality:It is safe guard the client’s right to privacy by
carefully protecting information of the client. Gossiping violates nursing ethical codes and standards.
Trustworthiness:Being trustworthy means helping others
without hesitating. To foster trust the nurse communicates warmth, demonstrates consistency, reliability and honesty.
![Page 37: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/37.jpg)
Autonomy and responsibility:It is the ability to be self directed in
accomplishing the goals. Nurses can take initiative for problem solving. Nurses support client autonomy by respecting the person’s rights, values and decisions.
![Page 38: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/38.jpg)
Follow certain limitations .
Avoid too personal involvement .
Ambiguity and misunderstanding with other staff has to be avoided.
Avoid adverse feelings.
Ethics and moral principles have to be followed
RESPONSIBILITIES OF A NURSE IN THERAPEUTIC COMMUNICATION
![Page 39: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/39.jpg)
Summarization
![Page 40: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/40.jpg)
Recapitulization
![Page 41: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/41.jpg)
ANY QUERY
![Page 42: Therapeutic commnication](https://reader031.fdocuments.us/reader031/viewer/2022032122/55d167c1bb61ebd0598b4652/html5/thumbnails/42.jpg)
THANK YOU