This document provides information on communication skills for working with clients. It defines communication, lists its components, and describes the characteristics of effective communication. These include providing a safe environment, forming relationships, clarifying conflicts, respecting cultural values, and encouraging socialization. The document also outlines principles of communication, such as treating clients as individuals and maintaining objectivity. It then describes the process of communication including the sender, medium, channel, receiver, feedback, and context. Different types of communication are defined like formal vs informal, downward vs upward vs horizontal, and verbal vs non-verbal. Finally, techniques for active listening and communication are presented, along with their rationales.

1. 1
COMMUNICATION
SKILL

2. WHAT IS COMMUNICATION??
• "It is a process by
which two or more
people exchange their
ideas and knowledge
through a medium of
symbol"

3. COMPONENTS
• Genuineness
• Sincerity
• Respecting the client
• Shows love and affection
• Concern
• Active listening
• Empathy
• Concreteness- speaking in a realistic way
• Self-discipline
• Good communication skills in order to establish rapport
with the client

4. CHARACTERISTICS
• To provide safe and therapeutic environment.
• Ability to form intimate, interdependent ,
interpersonal relationships with client and his
family.
• Achieves realistic goals.
• Improves functioning capacity.
• Increased ability to satisfy and fulfill the needs
of the client.

5. Cont…
• Ability to give and receive love.
• Time is limited.
• Clarifies client's conflicts and anxiety.
• Allows time for the client to complete the
rituals.
• Respect the cultural values of the client.
• Encourages socialization and family
relatedness.

6. Principles Of Communication
• Treat the client as an individual.
• Accept the client as he is.
• Aware total needs of the client.
• Emotional involvement is essential.
• Objectivity has to be maintained.
• Consistency in behavior.
• Set appropriate limits and goals.

7. Cont…
• Encourage the client's feelings.
• Honest and open communication is needed.
• Engage in active listening.
• Evaluate client's weakness and potentialities.
• Realistic approach.
• Establish trust and rapport.
• Win the confidence of client.
• Provide sufficient time to the client

8. PROCESS OF COMMUNICATION

10. SENDER/ ENCODER
• The sender also
known as the
encoder, decides
on the message to
be sent, the best
and the most
effective way to be
sent.

11. MEDIUM
• The medium is the
immediate form which a
message takes.
For e. g. A message may be
transmitted in the form of
a letter or email or face to
face in the form of a
speech.

12. C
H
A
N
N
E
L
• The channel is
that which is
responsible for
the delivery of
the chosen
message form.
For e.g. post
office, internet ,
radio.

13. RECEIVER
• The receiver or the decoder is
responsible for
extracting/decoding meaning from
the message.

14. FEEDBACK
• Feedback is important as it
determines whether or not the
decoder grasped the intended
meaning and whether
communication was successful.

15. CONTEXT
• Communication does not take place
in a vacuum.
• The context of any communication
act as the environment surrounding
it. This includes among other things,
place, time , event and attitudes of
sender and receiver.

16. METHOD OF COMMUNICATION
• On the basis of relationship-
Formal and Informal
• On the basis of direction-
Downward
Upward
Horizontal
• On the basis of expression-
Verbal
Non-verbal

17. Formal communication
Formal
communication is
straightforward,
official and always
precise and has a
stringent and rigid
tone to it.

18. Informal
communication
This is the process
in which individual
carry out social but
unscheduled
activities within the
limits of an
organization who
share a casual
rapport with each
other

19. Downward
Communication
This communication
flows from top to
bottom and the main
objective is to convey
orders, directions,
instruction etc.

20. Upward
Communication
This communication
is from the
subordinate staff to
the superior who
flows in the form of
reports complaints
and suggestion.

21. Horizontal
Communication
This is the
exchange of
information
between individual
of the same status
or designation.

22. Verbal
Communication
Verbal
communication is the
use of words in
delivering your
intended message.
•It is an accurate and
effective medium of
communication.

23. NON VERBAL
COMMUNICATION
Facial expression
Gestures
Body language
Personal space
Touch
 Appearance

24. Intimate <16”-18”
Personal 18” to 4 feet
Social--4 ft to 12 ft
Public > 12 ft.
CONVERSATIONAL DISTANCES

25. Communication Technique

26. • Using Silence
• Accepting
• Giving Recognition
• Offering Self
• Giving Broad Opening
• Offering General Leads
• Placing The Event In Time Or Sequence
• Making Observations
• Encouraging Description Of Perception

27. • Encouraging comparison
• Restating
• Reflecting
• Focusing
• Exploring
• Seeking clarification and validation
• Presenting reality
• Voicing doubt
• Verbalizing
• Attempting to translate words into feeling
• Formulating a plan of action

28. ACTIVE LISTENING
•Active process of
receiving the
information
•Active listening
shows respect
towards the person
who is speaking

29. RATIONALE
•Allows the client to talk more
without any inhibitions or
bias. It maintains trust or
confidentiality.

30. SILENCE
Absence of verbal
communication, which
provides time for the
client to put thoughts or
feelings into words,
regain composure, or
continue talking.

31. RATIONALE
31
Silence demonstrates the nurse's
patience and willingness to wait for a
response, when the client is unable to
respond quickly. Silence may be
therapeutic during the times of profound
distress or grief.

32. What are you thinking about?
What would you like to discuss?

33. RATIONALE
33
•Broad openings make explicit that the client
has the lead in the interaction.
• It emphasis the client role in interaction.
•For the client who is hesitant about talking,
broad openings may stimulate him or her to
take the initiative

34. I noticed that you dressed and put
make-up on today.
You’ve really been participating in
groups today.
Shyama, I see you made your bed.

35. 35
Rationale
Greeting the client by name,
indicating awareness of change,
or noting efforts the client has
made all show that the nurse
recognizes the client as a person,
as an individual.

36. I would like to spend time with you.
I’ll stay here and sit awhile.
You seem upset, would you like to
talk?

37. RATIONALE
• The nurse can offer his or her presence,
interest and desire to understand. It is
important that this offer is unconditional,
that is, the client does not have to
respond verbally to get the nurse’s
attention. It increases the feeling of self-
worth.

38. •Yes I see.
•Go on
•Nodding of head
•Leaning forward

39. RATIONALE
39
•General leads indicate that the nurse is
listening and following what the client is
saying without taking away the initiative
for the interaction.
•They also encourage the client to
continue if he or she is hesitant or
uncomfortable about the topic.

40. •When did you do this?
•What led up to………?
•How old were you when this
occurred?

41. Rationale
• Putting events in proper sequence helps both the
nurse and client to see them in perspective.
• The client may be able to see that perhaps some
things are not related.
• The nurse may gain information about recurrent
patterns or themes in the client’s behavior or
relationships.

42. You appear
anxious.
I notice you are
biting your lips.
You seem restless.

43. RATIONALE
•Sometimes clients cannot
verbalize or make themselves
understood or the client may
not be ready to talk.
•This encourage the client to
recognize specific behavior.

44. ENCOURAGING DESCRIPTION OF
PERCEPTIONS
“ Tell me what is happening now?”
“Are you hearing the voices again”

45. RATIONALE
45
To understand the client, the nurse must
see things from his or her perspective.
Encouraging the client to describe ideas
fully may relieve the tension the client is
feeling. This is often used with client
experiencing hallucination.

46. P: My children are going through a financial
problem because I am sick
N: Your children are going through a financial
problem because you are Sick.
Client: “I can’t sleep. I stay awake all night.”
Nurse: “You have difficulty sleeping.”
Client: “I’m really upset.”
Nurse: “You’re really upset.”

47. RATIONALE
• This restatement lets the client know
that he or she communicated the
idea effectively.
• This encourages the client to
continue. Or if the client has been
misunderstood, he or she can clarify
his or her thoughts.

48. Client: “Do you think I should
divorce my wife?
Nurse: “Do you think you should?”.

49. RATIONALE
• Reflection encourages the client to
recognize and accept his or her own
feelings.
• The nurse indicates that the client’s point
of view has value, and that the client has
the right to have opinions, make
decisions, and think independently

50. • I think we should talk more about your relationship
with your father.
• What happens when you feel this way

51. RATIONALE
• The nurse encourages the client to
concentrate his or her energies on a
single point, which may prevent a
multitude of factors or problems from
overwhelming the client.
• It is also a useful technique when a client
jumps from one topic to another

52. Tell me more about that?
Give me an example of one time
you thought everyone hated
you?

53. RATIONALE
• When clients deal with topics superficially,
exploring can help them examine the issue
more fully.
• Any problem or concern can be better
understood if explored in depth.
• If the client expresses an unwillingness to
explore a subject, however, the nurse must
respect his or her wishes.

54. I’m not sure what you mean. Could
you tell me about that again?
Did these feelings start after the
incident happened or were you feeling
this way before?

55. Rationale
• Doing so can help the nurse to avoid
making assumptions that
understanding has occurred when it
has not.
• It helps the client to articulate
thoughts, feelings, and ideas more
clearly

56. PRESENTING REALITY
“I understand that the voices seem
real to you, but I do not hear any
voices.”
“There is no one in the room but
you and me.”

57. RATIONALE
•The nurse does this by calmly ,not by
way of arguing with the client or
belittling his or her experience.
•The intent is to indicate an alternative
line of thought for the client to
consider, not to “convince” the client
that he or she is wrong.

58. ATTEMTING TO TRANSLATE
WORDS INTO FEELING
• Client: “I’m dead.”
• Nurse: “Are you suggesting that you feel
lifeless?”
• Client: “I’m way out in the ocean.”
• Nurse: “You seem to feel lonely or deserted.”

59. RATIONALE
• Often what the client says, when taken
literally, seems meaningless or far
removed from reality.
• To understand, the nurse must
concentrate on what the client might be
feeling to express himself or herself this
way.

60. During the past hour we
have discussed…………
So far we have talked
about…………
SUMMARIZING

61. RATIONALE
61
•Summarization seeks to bring out
the important points of the
discussion
•It allows both client and nurse to
depart with the same ideas and
provides a sense of closure at the
completion of each discussion

62. BOUNDARY VIOLATION
• It occurs when the person goes outside
the boundaries of relationship and
establishes a personal, social relationship
with the client. Whenever the person
does anything unusual or different to the
client, a boundary violation results.

63. BARRIERS OF
COMMUNICATION

64. • Noise
• Inappropriate
medium
• Emotions
• Language
differences
• Poor listening skills
• Distractions

65. CONCLUSION

66. Therapeutic communication in
Nursing reinforces the nurse client
relationship. It makes the nurse more
human. Modern health care system
are seeking to adopt more client-
oriented approach to the delivery of
health care