Communication is the sharing of messages between individuals. It may be transmitted orally, by the written word or by the use of body language. Therapeutic communication is a tool employed by health professionals to facilitate discussion with the patient. It is an important part of building a therapeutic interpersonal relationship, explains "Psychiatric Mental Health Nursing". Nurses, mental health professionals and other health care professionals use therapeutic communication during each patient interaction, whether educating the patient or eliciting information for analysis. This type of communication utilizes several specialized techniques.
Restating what the patient has said shows him that the nurse has listened to and understands what he has articulated. It may also give the patient a new perspective on his situation.
Patient: "I won't ever be able to use this electric wheelchair!" Nurse: "You're concerned that you won't be able to use the devices on your new wheelchair."
In this scenario, the psychiatrist asks the patient an open-ended question to facilitate the opportunity for a broad response. As opposed to a closed-ended question, this type of communication avoids the perception of judgment and allows the patient to speak what is truly on his mind regarding the topic.
Psychiatrist: "What kind of relationship did you have with your mother?" Patient: "She was horrible to me but good to my brother and I was the one who tried to please her."
A closed-ended question may be non-therapeutic in this circumstance:
Psychiatrist: "Did you have a good relationship with your mother?" Patient: "It was all right."
The therapist may make an observation when he notices that the patient isn't talking about how he feels. This may help the patient verbalize his feelings, explains NurseReview.org.
Therapist: "You seemed angry with your son today." Patient: "Yes, he really hurt my feelings by telling people that I'm crazy. Who does he think he is? I worked 12 hours a day putting him through school and now he treats me like this."
The doctor may use verbal and nonverbal cues to convey unconditional acceptance of the patient's feelings. This allows the patient to feel understood and comfortable to continue to explain her feelings. Not arguing with the patient's point of view gives her the opportunity to fully consider the issue without feeling defensive.
Patient: "I am so disappointed that my husband put me in this nursing home." Doctor: "I understand." The doctor makes eye contact with the patient and nods his head. Patient: "I guess I can sort of understand it. His arthritis keeps him in a lot of pain, making it hard for him to take care of me."
Being silent gives the patient an opportunity to consider his thoughts, explains Michael Zychowicz, a Mount Saint Mary College faculty member. The psychologist shows the patient her support by sitting quietly with him as he collects his thoughts, fostering the therapeutic relationship.
The psychiatrist is silent or says, "I will sit quietly with you; I can tell you have something serious on your mind."
- “Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice”; Mary C. Townsend, M.N., A.P.R.N.; 2006
- NurseReview.org: Therapeutic Communication Techniques
- Mount Saint Mary College: Faculty Member Michael Zychowicz: Therapeutic Communication