1. THERAPEUTIC COMMUNICATION

9. Components of the Nurse-Client Relationship • Trust • Genuine interest • Empathy • Acceptance • Positive Regard • Therapeutic Use of Self

10. Types of relationships

11. Types of interpersonal relationships • Kinship relationships (including family relationships) involve relating to someone else: • genetically (consanguinity, as for example in fatherhood, motherhood) • through marriage (affinity, as for example as a father-in-law, mother-in-law, uncle by marriage, aunt by marriage)

12. Formalized intimate relationships long-term relationships recognized by law and formalized through public ceremony (for example, the relationships of marriage and of civil union)

13. Non-formalized intimate relationships long-term relationships such as loving relationships or romantic relationships with or without living together; with the "other person" often called lover, boyfriend or girlfriend (as distinct from just a male or female friend), or "significant other“. • If the partners live together, the relationship may resemble marriage, with the parties possibly called "husband" and "wife".

14. Soulmates, individuals intimately drawn to one another through a favorable "meeting of minds" and who find mutual acceptance and/or understanding with one another. Soulmates may feel themselves bonded together for a lifetime; and hence may become sexual partners — but not necessarily. • Casual relationships sexual relationships extending beyond "one-night stands" that exclusively consist of sexual behavior; one can label the participants as "friends with benefits" when limited to considering sexual intercourse, or regard them as sexual partners in a wider sense.

15. Platonic love an affectionate relationship into which the sexual element does not enter, especially in cases where one might easily assume otherwise. • Friendship which consists of mutual love, trust, respect, and (often unconditional) acceptance; and usually implies the discovery or establishment of common ground between the individuals involved; see also internet friendship.

16. Partners or co-workers in a profession, business, or a common workplace. Compare team. • Participation in a community, for example, a community of interest or practice.

17. Phases of the Nurse-Client Relationship: • Pre-Orientation- Self assessment examine own feelings, fears, anxieties. • Orientation – Introductory Phase establish trust, share information with client; discrete self-disclosure. convey support, facilitate healing educate

18. The Working Phase – Problems identified Exploration- guide client to examine feelings/responses, develop new coping skills. • Termination Phase – Resolution phase Examine goals achieved; Explore feelings regarding termination Establish plan for continuing assistance

19. Obstacles to the Therapeutic Relationship: • Inappropriate Boundaries • Encouraging dependence • Non acceptance/Avoidance • Resistance

20. Roles of the Nurse: • Teacher • Caregiver • Advocate • Parent- Surrogate

22. Characteristics of communication

23. Responsive dimensions • Genuineness- the nurse is open, honest, and sincere. • Respect- unconditional positive regard. The nurse’s attitude is nonjudgmental. • Empathy- sensitivity to the pt’s current feelings and the verbal ability to communicate this understanding. • concreteness

24. Action dimensions • Confrontation • Immediacy • Therapist self-disclosure • Catharsis • Role playing

25. Therapeutic Communication • Boundaries: • Intimate • Personal • Social • Public

26. Non Verbal Communication • Eye Contact • Body Language • Boundaries • Facial Expressions • Silence • Vocal cues

27. Non Verbal Communication • Space (comfort zone) • Touch ( action/personal space – used cautiously) • Appearance – communicates a particular image/one’s mental status ( use of clothing, make-up etc.) • Be aware of own non-verbal cues!!

28. Traits of Therapeutic Communication • Genuineness • Positive Regard • Empathy • Trustworthiness • Clarity • Responsibility • Assertiveness

29. Conditions Affecting Communication • Values • Attitudes • Beliefs • Perceptions • Culture or Religion • Social Status • Gender • Age or developmental level • Environment

30. Enhancing Communication • Silence • Support/reassurance • Sharing Observations • Acknowledge feelings • Broad – open ended statements • Information giving • Interpretation

33. Active listening • Expression of interest. • Leaning forward. • Nodding head. • Verbalizations such as “Uh-huh” and “Go on…” • Frequent validation. • Attempt to fully understand.

34. Active Listening!! • S – Sit facing the client • O – Open Posture • L – Lean forward towards client • E – Establish eye contact • R- Relax!!

36. Open-ended questions • “Tell me what happened?” • “How are you today?”

38. Restating • Pt.: “I couldn’t sleep all night.” • Nurse:”You couldn’t sleep all night.” or “You couldn’t sleep all night?” • Pt.: “My husband is very worried about me.” • Nurse:”Your husband is very worried about you.” “Your husband is very worried about you?”

40. Clarifying, validating • “I’m having some difficulty. Could you help me understand?”

42. Reflecting or validating signifies understanding, empathy, interest, and respect for the patient. It consists of repeating in fewer and different words the essential ideas of the patient. (similar to paraphrasing). Reflection can refer to content or feelings.

45. Informing • “I think you need to know more about how your medication works.”

47. Focusing • “Can we continue talking about your mother right now?”

50. Theme Identification • “I’ve noticed that in all of the relationships that you have described, you’ve been hurt or rejected by the man. Do you think this is an underlying issue?”