Using Therapeutic Communication

1. THERAPEUTIC COMMUNICATION
communicating can be difficult and frustrating
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o when clients are hallucinating, withdrawing from reality, or relatively mute
o maintain nonverbal communication esp since verbal communication is not very
successful
o involves spending fairly lengthy periods of silence
Use therapeutic communication techniques to collaborate in assessment & planning
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o offer support & encouragement to client to help manage anxiety responses
o validate the overwhelming feelings that client experiences while indicating the
belief that the client can make needed changes & regain a sense of control
o encourage client to talk about feelings & to describe in detail as the client can
tolerate
Use a soothing, calm voice
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Keep communication simple & calm
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Evaluate the use of touch
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therapeutic use of self – for clients with reality orientation & verbal communication
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difficulties
o can demonstrate the nurse’s genuine interest and caring to the client
o use of self is a contact with reality for the client
calling client by name
making references to the day and time
commenting on the environment
o clients who are left alone for long periods become more deeply involved in their
psychosis, so frequent contact and time spent with client are important even if
nurse is unsure that client is aware of the nurse’s presence
active listening for clients with disorganized or nonsensical
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o rather than dismissing the unclear statements of clients, nurse must make efforts
to determine the meaning the client is trying to convey
o listening for theme or recurrent statements, asking clarifying questions, and
exploring meaning to client’s statements
o nurse must let client know when his meaning is not clear – never pretend to
understand or just to agree
Nurse: “How are you feeling today?” (broad opening statement)
Client: “Invisible.”
Nurse: “Can you explain that to me?” (seeking clarification)
Client: “Oh it doesn’t matter.”
Nurse: “I’m interested in how you feel; I’m just not sure I understand.”
(offering self/seeking clarification)
Client: “It doesn’t mean much.”
Nurse: “Let me see if I can understand. Do you feel like you’re being
ignored, that no one is really listening?” (verbalizing the implied)
When anxiety has subsided, as open ended communication techniques to discuss the
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experience
ESTABLISHING THERAPEUTIC COMMUNICATION
Establishment of trust – to allay fears of a frightened client
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o be patient → Initially, client can tolerate 5-10 minutes of contact at one time
o provide explanations that are clear, direct and easy to understand
o body language
eye contact but not staring
relaxed body posture

2. facial expressions that convey genuine interest and concern
o telling client one’s name & calling client by name – helps in establishing trust as
well as reality orientation
Use of touch – assess carefully the client’s response
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