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Prepared by: Joseph Alvin C. Paulino, RN., MAN. Faculty of Nursing Bulacan State University
Therapeutic Communication
Is an interactive process that occurs between the
feelings, and ideas so the nurse can understand the patients problems and develop interventions that will strengthen his insight and self-control;
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the nurse and the patient; The nurse must have profound knowledge and understanding of the NursePatient Relationship.
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Nurse must display sincere interest using consistent words and actions; This promotes openness, self-acceptance, and personal freedom of the patient.
2. Respect
Nurse must have an unconditional positive regard for the patient; Non-judgemental acceptence of the patients ideas and beliefs.
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3. Honesty
A consistent, open, and frank, approach promotes
4. Concreteness
Nurse should use clear, specific, and concrete
5. Assisstance
Nurse must exhibit a wiling commitment and will stay
with the patient; By staying with the patient, the nurse have something of value to offer the patient.
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6. Protection
Patient must feel safe from threat and confrontations.
7. Permission
Patient must feel free to explore new ways on dealing
with past problems in order to built autonomy; Patients learning to try alternative behaviors is central to eliminating the patients problems.
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2. Restating
Rephrasing helps ensure the nurses understanding and emphasizes important points in the patients statements; You said that you wanted to hurt yourself?
General statements or questions that begin with WHAT, WHEN, WHERE and HOW to initiate a conversation.
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4. Clarifying
Attempting to put a patients confusing or vague
message into words or asking the patient what she or he means; I dont think I understand what you are saying.
5. Confrontation
Calls attention to discrepancies the nurse perceives in
6. Focusing
Keeps the communication goal-oriented and foster the
7. Suggesting
Presenting alternatives for the patient to consider; Gives the patient the opportunity to explore the
8. Sharing perceptions
The nurse describes his or her understanding of the
patients feelings and then seeks corrective feedback from the patient.
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9. Identifying themes The nurse states the experience, issues, or problems the patients discloses repeatedly during the interaction. 10. Reflecting The nurse repeats the patients ideas, feelings, questions, or content; It imparts interest, empathy and respect for the patient.
11. Silence. 12. Showing empathy.
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13. Validating
Checking perception of clients statements.
14. Summarizing
Putting together salient points of a previous interaction.
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4. Using emotionally charges language This may reinforce the patients symptoms
5. Straying from patients agenda Altered focus will send information to the patient that the nurse is not interested in the communication 6. Delivering double message The patient will find it difficult to understand the meaning of the message 7. Rejecting clients statements 8. Agreeing and disagreeing with the client
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Therapeutic Relationship
Is a relationship by the nurse and the client that
Contract
The nurse must establish the time, place, and purpose of every meetings as well as the conditions for terminating the meetings.
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2. Boundaries
The roles of the participants are clearly defined and
observed The clients needs and concerns are the focus of the interaction
3. Confidentiality
Basic condition of the interaction and needs to be
observed by the nurse The nurse shares client information only with a professional staff that needs to know the interactions The nurse must obtain the consent of the patient if an information must be shared to others outside the treatment team.
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Assessment or analysis stage The patient feels in need and will seek help The nurse establishes trust with the client Establishment of contract The nurse assesses the client Formulation of diagnosis Prioritization of the clients problems The nurse and the client establish mutually agreed goals Preparation for termination begins
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B. Working Phase
Or the identification and exploration stage The nurse plans outcomes and related interventions to
assist client to meet goals The nurse facilitates the clients expression of problems, thoughts, and feelings The nurse uses problem-solving approach The nurse encourages and teaches coping measures The nurse encourages the client to practice adaptive behaviors and evaluates the effectiveness of these efforts There is clarification of perceptions and expectations about the relationship
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C. Termination stage
Or resolution stage The nurse evaluates outcomes, reassess the problems,
goals, and interventions Needs close attention to avoid destroying the benefits gained from the relationship The nurse and client express feeling regarding the termination of the interactions The nurse observes the client for regressive behaviors The nurse evaluates the entire nurse-client relationship
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