COMMUNICATION SKILLS

HPR 450Chapter 6

INTERPERSONAL COMMUNICATION Without these effective interpersonal

communication skills the TR Process is doomed to failure

Listening Counseling Leader communication Interviewing Clients with special needs

Communication skills are used in all parts of our lives

Communication process includes 5 elements Communicator - Who Message – Says What Medium – In What Way Receiver - To Whom Feedback – With What Effect

VERBAL COMMUNICATION Four Factors

Presentation of the material in terms of Vocabulary and Clarity

Speaker’s attitude – Concern and caring Voice tone and volume - Tone of voice

(inflection) Speaker’s and Receiver’s ability to listen

EFFECTIVE LISTENING SKILLS Attending – (eye contact, posture,

gestures, verbal behavior) Paraphrasing – restated in similar but

fewer words Clarifying – I’m confused…would you go

over that again? Perception Checking – “You seem to be

happy. Is that right?”

TABLE 6-1ATTENTIVE LISTENING USING ACRONYM “SOLER”

S − Sit squarely facing the clients.O − Observe an open posture.

(arms and legs uncrossed)L − Lean forward toward the client.E − Establish eye contact.R − Relax.

Source: Adapted from Egan, G. (2002). The skilled helper: A problem management approach to helping (7th edition). Pacific Grove, CA: Brooks/ Cole Publishing Company & Townsend, M. C. (2000). Psychiatric mental health nursing: Concepts of care (3rd edition). Philadelphia: F. A. Davis Company.

VERBAL TECHNIQUES FOR HELPING PROFESSIONALS TO EMPLOY – TABLE 6-2

Minimal verbal responses

Paraphrasing Checking out Clarifying Probing Reflecting Interpreting Confronting

Informing Summarizing Self-disclosing Focusing Making observations Suggesting Closed questions Facilitative questions

and statements

Effective communication in success-failure situations demands appropriate approaches from the leader

Understanding nonverbal communication is a critical skill for Helping professionals because approx 2/3 of communication is nonverbal

Following guidelines may prove to be helpful when communicating with persons with special needs (e.g., visually and/or hearing impaired)

Interviewing skills are basic for the CTRS

TABLE 6-3GENERAL GUIDELINES FOR USING MAJOR VERBAL TECHNIQUES

1. Phrase your response in the same vocabulary that the client uses.

2. Speak slowly enough that the client will understand each word.

3. Use concise rather than rambling statements.4. Relate the topic introduced by the client to the identified

cognitive theme that is of most importance.5. Talk directly to the client, not about him or her.6. Send “I” statements to “own” your feelings, and allow the

client to reject, accept, or modify your messages.7. Encourage the client to talk about his or her feelings.8. Time your responses to facilitate, not block, communication. Adapted from: Okun, B.F. (2002/ Effective helping: Interviewing and counseling techniques (6th ed.).

Pacific Grove, CA: Brooks/Cole.

TABLE 6-4FACILITATIVE QUESTIONS AND STATEMENTS

TypeObserve—to notice what went on or what goes on.

Example“Tell me about yourself.”“Tell me every detail from the beginning.”“To what degree do you feel that way?”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-4FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)

TypeDescribe—to stimulate recall and details of a specific event or experience.

Example“What did you feel at the time?”“What happened just before?”“How did he respond to your comment?”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-4FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)

TypeAnalyze—to review that information for greater understanding.

Example“What is the importance of event?”“What do you see as the reason?”“What was your part in it?”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-4FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)

TypeFormulate—to restate in a clear, direct way the relationship between thoughts, feelings, and experiences.

Example“Tell me again.”“What would you say was the problem?”“Can you tell me the essence of it?”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-4FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)

TypeTest—to try out new thoughts, feelings, or behaviors.

Example“What would you do if a situation like that came up again?”“In what way will this understanding help you in the future?”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-5BARRIERS TO THERAPEUTIC COMMUNICATION

BarriersGiving advice Giving false reassuranceTopic jumping (changing the subject)Interrupting

Non-Therapeutic Examples“If I were you…”“Don’t worry—everything will be OK.”“Let’s wait on that and talk about…”“Hold it, hold it!”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-5BARRIERS TO THERAPEUTIC COMMUNICATION (CONT.)

BarriersBeing judgmental BlamingGiving directionsExcessive questioningChallenging

Non-Therapeutic Examples“You’re wrong.”“It is all your fault.”“Just do what I say.”“What is the real reason?”“You can’t really hear the devil speaking.”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-5BARRIERS TO THERAPEUTIC COMMUNICATION (CONT.)

BarriersExpressing disapproval Hurried approachesClosed-mindedness, Stereotyped responses

Non-Therapeutic Examples“I don’t approve of that.” (or frowning)“Will you please hurry up.”“That’s the only way to see it.” “Keep your chin up; it won’t be much longer.”

Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-5BARRIERS TO THERAPEUTIC COMMUNICATION (CONT.)

BarriersDouble messages

Defending or defensive responsesSelf-preoccupation or daydreamingPatronizing

Non-Therapeutic Examples“Tell me more.” (While non-verbals show lack of interest.)“Don’t blame me; you’re the one with problems.”“Oh, excuse me; could you repeat that? I didn’t hear what you said.”“Now, Honey, it will work out.”Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon

& P. Price-Hoskins (Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).

TABLE 6-6COMMUNICATION WITH CLIENTS WITH SPECIAL NEEDS

Clients Who Are Visually Impaired Clients Who Are Hearing Impaired Clients Who Use Wheelchairs Clients Who Speak a Foreign

Language

TABLE 6-7TECHNIQUES FOR THE PRODUCTIVE INTERVIEW Establish rapport Control the external environment Wear clothing that conveys the image of a professional

and is appropriate for the situation. Begin by stating and validating with the client the

purpose of the interview. Use a vocabulary on the level of awareness or

understanding of the person.

Source: Murray, R.B., & Huelskoetter, M.M.W. (1991). Psychiatric/mental health nursing (3rd ed.). Norwalk, CT: Appleton & Lange: pp.139.

TABLE 6-7TECHNIQUES FOR THE PRODUCTIVE INTERVIEW (CONT.)

Avoid preconceived ideas, prejudices, or biases. Be precise in what you say, so the meaning is

understood. Avoid asking questions in ways that get only socially

acceptable answers. Be gentle and tactful when asking questions about

home like or personal matters. Be an attentive listener.

Source: Murray, R.B., & Huelskoetter, M.M.W. (1991). Psychiatric/mental health nursing (3rd ed.). Norwalk, CT: Appleton & Lange: pp.139.

TABLE 6-7TECHNIQUES FOR THE PRODUCTIVE INTERVIEW (CONT.)

Carefully observe nonverbal messages for signs of anxiety, frustration, anger, loneliness, or guilt.

Encourage spontaneity. Ask questions beginning with “What…?” “Where…?”

“Who…?” and “When…?” Keep data obtained in the interview confidential and share

this information only with the appropriate and necessary health team members.

Evaluate the interview.

Source: Murray, R.B., & Huelskoetter, M.M.W. (1991). Psychiatric/mental health nursing (3rd ed.). Norwalk, CT: Appleton & Lange: pp.139.