The document discusses therapeutic communication between nurses and patients. It defines therapeutic communication as focusing on a patient's specific needs to promote effective information exchange. Therapeutic communication has two dimensions: responsive, which requires skills like genuineness and empathy, and action-oriented, including techniques like confrontation and role playing. Barriers to communication and the phases of the therapeutic nurse-patient relationship are also examined. Process recording is introduced as a tool for self-evaluation and improving clinical interactions.

1. WELCOME
Ms. ANGELINE
MSC (N) PREVIOUS YEAR
CHOITHRAM COLLEGE OF NURSING

2. THERAPEUTIC
COMMUNICATION

3. Communication refers to the giving and
receiving of information. Communication
is the mean by which people influence the
behaviour of another, leading to the
successful outcome of nursing
interventions.

4. TYPES OF COMMUNICATION
.
VERBAL COMMUNICATION NON VERBAL
COMMUNICATION

5. THERAPEUTIC
COMMUNICATION
Therapeutic communication
is an interpersonal
interaction between the
nurse and the patient during
which the nurse focuses on
the patient specific needs to
promote an effective
exchange of information.

6. PRINCIPLES OR CHARACTERSTICS
OF THERAPEUTIC
COMMUNICATION
ACTION DIMENSIONRESPONSIVE DIMENSION

7. RESPONSIVE DIMENSION
•The nurse must possess certain
skills and qualities to establish
and maintain a therapeutic
relationship. The responsive
dimension are crucial in a
therapeutic relationship to
establish trust and open
communication. The nurses goal
is to understand the patient and to
help the patient gain self
understanding and insight.

8. RESPONSE DIMENSION
• Genuineness
• Respect
• Empathetic
understanding
• Concreteness

9. ACTION DIMENSION
•The action oriented
conditions for facilitative
interpersonal relationship
are confrontation ,
immediacy ,therapist self
disclosure , catharsis , role
play

10. ACTION DIMENSION
• Confrontation
• Immediacy
• Nurse self disclosure
• Patient self disclosure
• Catharsis
• Role play

11. THERAPEUTIC
COMMUNICATION TECHNIQUE
• Listening
• Broad opening
• Restating
• Clarification
• Reflection
•Humour
•Informing
•Focusing
•Sharing perceptions
•Theme identification
•Silence
•Suggesting

12. BARRIERS OF
COMMUNICATION WITH
SPECIFIC REFERANCE
TO PSYCHPATHOLOGY

13. DYNAMICS OF THERAPEUTIC
NURSE PATIENT REALTIONSHIP:
• In a therapeutic
relationship the nurse and
client work together
towards the goal of
assisting the client to
regain the inner resources
to meet life challenges
and facilitate growth.

14. TYPES OF RELATIONSHIPS
Social relationships.
Intimate relationships.
Therapeutic relationship

15. PRINCIPLES OF THERAPEUTIC
NURSE-PATIENT RELATIONSHIP
• Treat the client as an individual
• Accept the client as he is
• Aware the total need of the client
• Nurse understand herself and clients needs , motives,
desires , feelings and tears
• Emotional and involvement is essential

16. • Objectivity has to be maintained
• Consistency has to be maintained
• Set approximate limits and goals
• Encourage the client feelings
• Therapeutic understanding
• Honest and open communication is needed
• Engage in active listening

17. THERAPEUTIC USE OF SELF
GAINING SELF AWARENESS
• In nurse patient relationship each interaction
is unique because the patient and the nurse are
having their even beliefs , values , attitudes ,
and behaviour .

18. JOHARI WINDOW

19. THERAPEUTIC NURSE PATIENT
REALTIONSHIP ITS PHASE
Four phases of relationship
process have been identified
• Pre-interaction phase
• Introductory or orientation phase
• Working phase
• Termination phase

20. • Term therapeutic impasse may be used to
describe a number of situations that can arise
in psychotherapy. Impasses can occur as a
result of disagreement between the therapist
and client, unacknowledged issues within
therapy, or stagnation in therapy..
THERAPEUTIC
IMPASSES

21. The common four impasses are :
Resistance
Transference
Counter transference
Boundary violations

22. •Process recording is a
written account or
verbatim recording of all
that transpired, during
and immediately
following the nurse-
patient interaction.
PROCESS RECORDING

23. AIMS OF PROCESS
RECORDING:
The aim of process
recording is to improve the
quality of interaction of
better effect to the patient
and a learning experience
for the nurse to continuously
improve her clinical
interaction pattern.

24. PURPOSE / OBJECTIVE /GOALS
Process recording will be used as a :
• Teaching tool
• Communicate tool
• Self evaluating tool
• Diagnostic tool
• Therapeutic tool
• A prerequisites for nursing process

25. PHASES IN PROCESS
RECORDING
Preparing the students for process
recording
Recording nurse patient interaction
Evaluating the interaction by the
instructor and the student ‘

26. :
• Physical setting
• Getting consent of the patient for
the possibility of cassette
recording
• Confidentiality
PRE REQUISITIES FOR PROCESS
RECORDING

27. OUTLINE FOR
PROCESS
RECORDING