انت هنا الان : شبكة جامعة بابل > موقع الكلية > نظام التعليم الالكتروني > مشاهدة المحاضرة

Relationship Development and Therapeutic Communication

الكلية كلية التمريض     القسم قسم التخصصات التمريضية     المرحلة 2
أستاذ المادة عبد المهدي عبد الرضا حسن الشحماني       13/12/2016 06:07:12
Relationship Development and Therapeutic Communication

Introduction
The nurse-client relationship is the foundation on which psychiatric nursing is established.
The therapeutic interpersonal relationship is the process by which nurses provide care for clients in need of psychosocial intervention.
Introduction (cont.)
Therapeutic use of self is the instrument for delivery of care to clients in need of psychosocial intervention.
Interpersonal communication techniques are the “tools” of psychosocial intervention.
The Therapeutic Nurse-Client Relationship
Therapeutic relationships are goal- oriented and directed at learning and growth promotion.
Goals are often achieved through use of the problem-solving model
The Therapeutic Nurse-Client Relationship (cont.)
The Problem Solving process consists of a sequence of sections that fit together depending on the type of problem to be solved. These are:
Problem Definition.
Problem Analysis.
Generating possible Solutions.
Analyzing the Solutions.
Selecting the best Solution(s).
Conditions Essential to Development
of a Therapeutic Relationship
Rapport
Trust
Respect
Genuineness
Empathy
Phases of a Therapeutic Nurse-Client Relationship
Pre-interaction phase
Obtain information about the
client from chart, significant
others, or other health
team members and emphasis is on the self-analysis of the nurse.
Phases of a Therapeutic Nurse-Client Relationship (cont.)
Orientation (introductory) phase
Create an environment for trust and rapport.
Gather assessment data.
Identify client’s strengths and weaknesses.
Phases of a Therapeutic Nurse-Client Relationship (cont.)
Orientation phase (cont.)
Formulate nursing diagnoses.
Set mutually agreeable goals.
Develop a realistic plan of action.
Explore feelings of both client and nurse.
Phases of a Therapeutic Nurse-Client Relationship (cont.)
Working phase
Maintain trust and rapport.
Promote client’s insight
and perception of reality.
Use problem-solving model to
work toward achievement of established goals.
Overcome resistance behaviors.
Continuously evaluate progress
toward goal attainment.
Phases of a Therapeutic Nurse-Client Relationship (cont.)
Termination phase
Therapeutic conclusion of relationship occurs when:
Progress has been made toward attainment of the goals
A plan of action for more adaptive coping with future stressful situations has been established
Feelings about termination of the relationship are recognized and explored
Patient anxieties reappear
Interpersonal Communication
Interpersonal communication is a transaction between the sender and the receiver. Both persons participate simultaneously.
In the transactional model, both participants perceive each other, listen to each other, and simultaneously engage in the process of creating meaning in a relationship.
The Impact of Preexisting Conditions (cont.)
There are four kinds of distance in interpersonal interactions:
Intimate distance - the closest distance that individuals allow between themselves and others
Personal distance - the distance for interactions that are personal in nature, such as close conversation with friends
Social distance - the distance for conversation with strangers
Public distance - the distance for speaking in
public or yelling to someone some distance
away
Nonverbal Communication
Components of nonverbal communication
Physical appearance and dress
Body movement and posture
Touch
Facial expressions
Eye behavior
Therapeutic Communication Techniques
Using silence - allows client to take control of the discussion, if he or she so desires
Formulating plan of action - striving to prevent anger or anxiety escalating to unmanageable level when stressor recurs
Offering self - making oneself available
Giving broad openings - allows client to select the topic
Therapeutic Communication Techniques (cont.)
Offering general leads - encourages client to continue
Placing the event in time or sequence - clarifies the relationship of events in time
Exploring - delving further into a subject, idea, experience, or relationship
Therapeutic Communication Techniques (cont.)
Encouraging comparison - asking client to compare similarities and differences in ideas, experiences, or interpersonal relationships
Restating - lets client know whether an expressed statement has or has not been understood
Focusing - taking notice of a single idea or even a single word
Nontherapeutic Communication Techniques
Rejecting - refusing to consider client’s ideas or behavior
Approving or disapproving - implies that the nurse has the right to pass judgment on the “goodness” or “badness” of client’s behavior
Nontherapeutic Communication Techniques (cont.)
Agreeing or disagreeing - implies that the nurse has the right to pass judgment on whether client’s ideas or opinions are “right” or “wrong”
Probing - pushing for answers to issues the client does not wish to discuss causes client to feel used and valued only for what is shared with the nurse
Introducing an unrelated topic - causes the nurse to take over the direction of the discussion
Nontherapeutic Communication Techniques (cont.)
Defending - to defend what client has criticized implies that client has no right to express ideas, opinions, or feelings
Belittling feelings expressed - causes client to feel insignificant or unimportant
Using denial - blocks discussion with client and avoids helping client identify and explore areas of difficulty
Active Listening
To listen actively is to be attentive to what client is saying, both verbally and nonverbally.
Several nonverbal behaviors have been designed to facilitate attentive listening.
Active Listening (cont.)
SOLER acronym
S – Sit squarely facing the client.
O – Observe an open posture.
L – Lean forward toward the client.
E – Establish eye contact.
R – Relax.
Feedback
Feedback is useful when it
is descriptive rather than evaluative and focused on the behavior rather than on the client
is specific rather than general
is directed toward behavior that the client has the capacity to modify
imparts information
is well-timed


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .