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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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Accepting (4) 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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Attempting to translate words into feelings (3) 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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Encouraging expression of feelings (4) 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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Making observations (6) 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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Validating perceptions (3) 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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Verbalizing the implied (2) 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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Using active listening (5) 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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Silence (4) 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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BRIEF self disclosure followed by returning the subject to the client's issues (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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Broad openings (3) TCT

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- "I'm not sure I understand yet." - "Help me to understand...." - Therapeutic Communication Technique

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Clarifying (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 comparisons (3) TCT

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- "Are you hearing the voices again? What are the voices telling you?" - Therapeutic Communication Technique

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Encouraging descriptions of perceptions (2) TCT

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- "Tell me more about..." - "Would you describe that more fully?" - Therapeutic Communication Technique

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Exploring (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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Focusing (3) 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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Forming a plan of action (5) 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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General leads (4) 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 feedback (5) 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 recognition (3) TCT

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- "Visiting hours are..." - "Bipolar disorder is..." - Therapeutic Communication Technique

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Giving information (3) 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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Offering self (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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Open-ended questions (4) 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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Paraphrasing/summarizing (3) 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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Placing the event in time or sequence (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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Presenting reality (4) 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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Reflecting (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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Restating (3) TCT

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- "Perhaps together we can figure out..." - Therapeutic Communication Technique

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Suggesting collaboration (2) 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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Voicing doubt (3) TCT

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- Deleting - Unspecified verbs - Universal qualifiers - necessity and possibility

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Unclear, Nonspecific communications and apropriate interventions

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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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Deleting (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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Unspecified Verbs (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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Universal qualifiers (3) 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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Necessity and possibility (4) UNCAI

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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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Agreeing/disagreeing (6) 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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All knowing (5) 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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Belittling expressed feelings (3) 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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Being judgmental (4) 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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Challenging (5) 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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Changing the topic (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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Close ended questions (4) 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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Defending (5) NCT

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