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COMMUNICATIONTECHNIQUES
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Communicationreciprocal exchange of ideas
between or among persons
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Modes:
Verbal - written/spoken
Non-verbal - posture,tone of voice, facialexpression
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Types of Non-verbal communication:
Kinesis
body movement
eye contact
gestures Paralanguage
voice quality
non-language vocalization (crying,
sobbing, moaning)
Proxemics law of space
relationship
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CONSIDERATIONS INTHERAPEUTIC
COMMUNICATION PRIVACY
RESPECTING BOUNDARIES
PROXEMICSscience of properspacing
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Distance Zones: 1. INTIMATE ZONE- 0-18 inches between
people; comfortable for parents with youngchildren, lovers or people whispering.
2. PERSONAL ZONE - 18-36 inches; distancebetween family and friends when talking
3. SOCIAL ZONE - 4-12 feet; acceptabledistance for communication in social, work &
business settings. 4. PUBLIC ZONE- 12 to 25 feet; acceptable
distance b/w speaker and audience, smallgroups, and informational functions.
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Touch physical act
Cultural artifacts eye glasses
uniform
beard
Meta communication
based on role expectations hidden meaning of words
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5 TYPES OF TOUCH: 1. FUNCTIONAL-PROFESSIONAL TOUCH- used in
examinations or procedures
2. SOCIAL-POLITE TOUCHused in greetings,handshake & air kisses, guiding someone for
direction 3. FRIENDSHIP-WARMTH TOUCH a hug in
greeting, an arm around a shoulder of a good friend orback slapping some men use to greet friends &
relatives.
4. LOVE-INTIMACY TOUCH involves tight hugs andkisses b/w lovers or close relatives.
5. SEXUAL AROUSAL TOUCHused by lovers.
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Always develop
ACTIVE LISTENINGmeans refrainingfrom other internal mental activities and
concentrating exclusively on what theclient says.
ACTIVE OBSERVATION means
watching the speakers nonverbal actionsas he/she communicates.
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Therapeutic Communication
A way of interacting in a purposefulmanner to promote the clients ability
to express his thoughts and feelingsopenly.
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ELEMENTS OF
COMMUNICATION SENDER originator of information
MESSAGE information being transmitted RECEIVER - recipient of information
CHANNEL - mode of communication
FEEDBACK - return response
CONTEXT - the setting of communication
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(Channel)
(Context)
Message
F E E D B A C K
Elements:
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Essentials for a Therapeutic
CommunicationGenuineness
RespectEmpathy
Attentive listening
Trust (rapport)
G RE A T
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Barriers to Therapeutic Communication
BelittlingInterrupting / ignoring
Giving advice
Social response
Changing the subject
Approving / disapproving
Moralizing
B
I
G
S
C
AM
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TYPES OF RELATIONSHIP:
SOCIAL RELATIONSHIP - initiated for thepurpose of friendship, socialization, companionshipor accomplishment of task
INTIMATE RELATIONSHIP involves two people
who are emotionally committed to each other. Mayinclude sexual or emotional intimacy and sharing ofmutual goals.
THERAPEUTIC RELATIONSHIP focuses on theneeds, experiences, feelings and ideas of theclient only. The nurse uses communication skills,personal strengths and understanding of human
behavior to interact with the client.
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Observe these in a Nurse-Patient
Relationship CONFIDENTIALITYmeans respecting the clients right
to keep private any information about his/her mental andphysical health and related care.
Note: if a patient tells a secret about harming oneself orothers, avoid keeping a promise not to tell the revealedinformation by the client.
DUTY TO WARN requires the nurse to notify
physicians, authorities, intended victims of a threat SELF-DISCLOSURE nurses disclosing personal
information to the patient which the nurse think can helpin establishing rapport.
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Accepting
E.g. Yes, that must have been difficult for you.
Acknowledging or giving recognition
E.g. I noticed that you've fixed your bed.
Asking direct questions
E.g. How does your wife feel about yourhospitalization?
Clarifying
E.g. I'm not sure that I understand what youare trying to say.
Confronting or presenting reality
E.g. I see no bats flying in this room.
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Giving broad openings or asking open-ended
questionsE.g. Is there something you'd like to do?
Informing giving needed facts
E.g. I'll be your nurse for today, from 7:00 until
3:00 this afternoon. Making observations
E.g. You appear to be angry. / I noticed thatyou're trembling.
Offering general leads
E.g. Go on. / You were saying
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Restating
E.g. Client: I can't sleep, I stay awake all
night. Nurse: You can't sleep at night,(restating)
Summarizing
E.g. During the past hour, we talked aboutyour plans for the future, they include...
Using silence- to induce thought, pacing,acceptance
Validating- confirming one's observation
E.g. So you mean . . .
Voicing doubt
E.g. I find that hard to believe.
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Non-therapeutic
and IneffectiveCommunication
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Agreeing and disagreeing
E.g. I think you did the right thing. Advice
E.g. You should..
Belittling
E.g. "Don't be concerned, evervonefeels like that".
Defending
E.g. "All doctors here are simply great".
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False reassuranceE.g. "Don't worry, everything will be all
right".
Focus on caregivers feelingE.g. I feel that way too.
Judging
E.g. "It's your own mistake".
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DEFENSE
MECHANISMS
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These are automatic and usually
unconscious processes or act by theindividuals to:
reduce or cope anxiety or fear
resolve emotional or mental conflictprotect one's self-esteem
protect one's sense of security
Becomes pathologic when overused. Used by both mentally healthy and
mentally ill individuals
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Common Defense
Mechanisms Used
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Compensation
An attempt to overcome a real or imagined
short coming, inferiority, inabilities andweaknesses.
A blind woman becomes proficient in playingpiano.
Conversion
Emotional problems are converted to physicalsymptoms
A student unprepared for a report sufferedheadache the day she is supposed to deliverher report.
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DenialFailure to acknowledge an intolerable thought,
feeling, experience or realityA middle-aged man after being admitted to
the CCU because of an AMI, insists that he isin the hospital for just a diagnostic work-up.
Displacement the redirection of feelings to a less threatening
objectAn adolescent boy, after an argument with his
father, goes to the room and kicked hisrooms door.
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Introjection
Symbolic assimilation or taking into oneself a
love/hatred object. Derived from the word"introject" which literally means to take into oringest.
Common to depressed clients.
Identification
An individual integrates certain aspects of
someone else's personality into one's own.A young school teacher adopts his former
mentor's teaching style when conductingclass sessions.
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Intellectualization
An overuse of intellectual concepts by anindividual to avoid expression of feelings
A man who was asked to share a memorableexperience about his grandmother who dieddiscussed the stages of death and dying byElizabeth Kubler Ross.
Projection
Attributing to others one's unconsciouswishes/fear.
Literally, this means to "throw off.
A student who failed a subject blames his failureon poor teaching.
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Reaction Formation
Expression of feeling that is the directopposite of one's real feeling.
Also referred to as overcompensation.
A student who dislikes one of her classmates
may act or show concern toward her.
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Rationalization
An individual finds a justifiable cause and acceptablereasons just to be saved from an embarrassing andanxiety producing thoughts or situations.
A basketball player claims that he missed the shotand lost the game because of the distractions madeby the audience.
Regression
Is the turning back to earlier patterns of behavior insolving personal conflicts.
Commonly seen to schizophrenic patients A person who becomes ill in the face of
disappointment has regressed to a form of childishbehavior.
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Repression
It is the involuntary or unconscious forgetting
of an unpleasant ideas or impulses.During the nurse-patient relationships,
patients often unconsciously avoid discussingthose experiences producing anxiety whichare emotionally difficult to verbalize.
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Suppression
Permits the individual to store away or
consciously forget the unpleasant, painful andunacceptable thoughts, desires, experiencesand impulses.
"I'll think it about tomorrow", "I'd rather gonow", "Can we change the topic?"
A boy walked out from the group and said "Ihave to go now", when he was asked what
was happened to their relationship with hisgirlfriend.
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Substitution
Replacing the desired unattainable goal withone that is attainable
A woman who failed the nursing board exam3 times, worked as a nursing aide just to be in
the hospital.
Sublimation
The redirection of unacceptable instinctualdrive with one that is socially acceptable
Instead of harming his mother, a manexpressed his anger by composing a song.
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SymbolizationLess threatening object is used to represent
anotherA woman, missing her husband finds comfort
in hugging her son who looks like his father.
UndoingAn attempt to erase an act, thought, feeling,
guilt or desire
A man gives her wife a bunch of roses aftertheir argument last night.