Mental health: Communication Techniques

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Accepting (4) TCT
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– “I can imagine how that might feel” – “That’s understandable.” – “It makes sense you might feel that way.” – Therapeutic Communication Technique
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Attempting to translate words into feelings (3) TCT
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– Pt “I’m way out in the ocean.” RN “You seem to feel lonely or deserted.” – Pt “My sister is so lazy!” RN “You sound angry that she doesn’t help.” – Therapeutic Communication Technique
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Encouraging expression of feelings (4) TCT
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– “What are your feelings about that?” – “How did you feel when…” – “That must have been painful for you.” – Therapeutic Communication Technique
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Making observations (6) TCT
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– [noting unexpressed feelings in nonverbal behavior] – “You seem tense.” – “You’re smiling yet you sound resentful.” – “You sound angry.” – “You look sad.” – Therapeutic Communication Technique
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Validating perceptions (3) TCT
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– “It sounds like you have sad feelings. Is that correct?” – “This is what I heard you say… Is that right?” – Therapeutic Communication Technique
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Verbalizing the implied (2) TCT
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– Pt “I can’t talk to you or anyone.” RN: “Are you feeling no one understands?” – Therapeutic Communication Technique
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Using active listening (5) TCT
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– Face pt; use open relaxed posture; – lean toward pt; – establish eye contact. – No touching without permission. – Therapeutic Communication Technique
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Silence (4) TCT
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– gives client time to organize thoughts, – think through a point, – introduce another topic of greater concern – Therapeutic Communication Technique
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BRIEF self disclosure followed by returning the subject to the client’s issues (3) TCT
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– “I experienced that too. My parents divorced when I was eighteen. Tell me more about how you coped …” – “I’m Filipino too. Tell me more about what is was like for you …” – Therapeutic Communication Technique
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Broad openings (3) TCT
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– “What would you like to talk about today?” – “What would be helpful to discuss?” – Therapeutic Communication Technique
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Clarifying (3) TCT
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– “I’m not sure I understand yet.” – “Help me to understand….” – Therapeutic Communication Technique
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Encouraging comparisons (3) TCT
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– “How does this compare to the last time it happened?” – “Have you had similar experiences?” – Therapeutic Communication Technique
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Encouraging descriptions of perceptions (2) TCT
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– “Are you hearing the voices again? What are the voices telling you?” – Therapeutic Communication Technique
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Exploring (3) TCT
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– “Tell me more about…” – “Would you describe that more fully?” – Therapeutic Communication Technique
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Focusing (3) TCT
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– “Which problem would be most helpful to focus on now?” – “Let’s focus on your feelings rather than your husband’s.” – Therapeutic Communication Technique
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Forming a plan of action (5) TCT
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– “How might you handle it differently in the future?” – “What could you do to let your anger out harmlessly?” – “Would you like to take a shower before breakfast?” – “Shall we take a walk to get your mind off the voices?” – Therapeutic Communication Technique
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General leads (4) TCT
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– using minimal encouragement – “Yes, I see, …and after that?” – “Go on (nodding)…uh huh… – Therapeutic Communication Technique
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Giving feedback (5) TCT
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– descriptive and focused on behavior that can be modified; – specific; – imparts well-timed information rather than advice] – In a family session, “When you raised your voice just now, your daughter looked scared.” – Therapeutic Communication Technique
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Giving recognition (3) TCT
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– “This is the first time you brought up your own problems to discuss in group therapy today.” – “Hello Ms. G.” – Therapeutic Communication Technique
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Giving information (3) TCT
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– “Visiting hours are…” – “Bipolar disorder is…” – Therapeutic Communication Technique
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Offering self (4) TCT
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– “I’m interested in what you think.” – “Let’s spend a half hour together this morning.” – “I’ll stay here with you while you’re feeling so anxious.” – Therapeutic Communication Technique
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Open-ended questions (4) TCT
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– “Tell me about your family.” – “What was the reason you stopped your medication?” – “How did she react?” – Therapeutic Communication Technique
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Paraphrasing/summarizing (3) TCT
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– “And so what bothers you the most is….” – “So far, we’ve discussed your plans to ….” – Therapeutic Communication Technique
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Placing the event in time or sequence (4) TCT
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– “Was this before or after…” – “When did you first notice…?” – “What seemed to lead up to….?” – Therapeutic Communication Technique
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Presenting reality (4) TCT
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– “I understand the voices seem real to you, but I don’t hear them. The only voices I hear are yours and mine.” – “Your mother is not here. I’m a nurse.” – “I see no one else in the room.” – Therapeutic Communication Technique
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Reflecting (3) TCT
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– Pt “Do you think I should tell the doctor?” – RN “Do you think you should?” – Therapeutic Communication Technique
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Restating (3) TCT
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– Pt “I can’t sleep. I lie awake all night.” – RN “You have difficulty sleeping.” – Therapeutic Communication Technique
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Suggesting collaboration (2) TCT
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– “Perhaps together we can figure out…” – Therapeutic Communication Technique
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Voicing doubt (3) TCT
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– “I’m not sure that’s possible. From my experience…” – “I’m surprised your teacher would have said that to you.” – Therapeutic Communication Technique
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Unclear, Nonspecific communications and apropriate interventions
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– Deleting – Unspecified verbs – Universal qualifiers – necessity and possibility
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Deleting (3) UNCAI
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– leaving out the object of the verb) – Pt “I’m afraid.” – RN “Afraid of what in particular?”
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Unspecified Verbs (3) UNCAI
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– action verb needs to be more specific – Pt “He really frustrates me.” – RN “How, exactly, does he frustrate you?”
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Universal qualifiers (3) UNCAI
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– words that generalize a few experiences into a multitude (all, every, never, always, nobody, only). – Pt “I never do anything right.” – RN “Has there ever been a time that you did do something right?”
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Necessity and possibility (4) UNCAI
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– statements that identify rules or limits to a person’s behavior and that often indicate no choice (have to, must, can’t, unable to, no one can) – Pt “I have to take care of people.” RN “What would happen if you didn’t ….?” – Pt “I can’t do it.” RN “What stops you from doing it?” – Pt “It’s impossible.” RN “What would need to happen to make it possible?”
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Agreeing/disagreeing (6) NCT
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– “You made the right decision.” – “I don’t see any reason for you to feel that way.” BETTER – “Let’s discuss…” – “How do you feel about it?” – “I can see why you might feel that way,” – Nontherapeutic Communication techniques
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All knowing (5) NCT
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– “I understand.” – “I know how you feel.” BETTER: – “It’s understandable.” – “It makes sense you would feel that way.” – Nontherapeutic Communication techniques
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Belittling expressed feelings (3) NCT
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– “Everybody gets down in the dumps at times.” BETTER: – “You must be very upset. Tell me…” – Nontherapeutic Communication techniques
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Being judgmental (4) NCT
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– “Homeless clients shouldn’t be on this unit.” – “Drug addicts are manipulative.” BETTER: – no comment or offer appropriate feedback – Nontherapeutic Communication techniques
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Challenging (5) NCT
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– “You didn’t mean to say that to her, did you?” – “You’re not in that much pain. I can tell.” BETTER: – “You must have been pretty angry to say that.” – “Describe your pain to me.” – Nontherapeutic Communication techniques
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Changing the topic (4) NCT
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– Pt “I don’t have anything to live for.” – RN responds “Let’s talk about something more pleasant.” BETTER: – silence, stay with the feelings, explore, OR ask to discuss later, seek supervision – Nontherapeutic Communication techniques
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Close ended questions (4) NCT
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– “Do….” “Is….” “Are….” BETTER – limited use; – open ended unless client very anxious or this is structured interview] – Nontherapeutic Communication techniques
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Defending (5) NCT
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– “No one here would lie to you.” – “You have a very capable physician…” BETTER: – “Let me answer your questions and clarify…” – “Let me find someone who can…” – Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques
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– Nontherapeutic Communication techniques

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