The document discusses therapeutic relationships between nurses and clients. It defines a therapeutic relationship as an interactive relationship that is caring, clear, boundaried, positive and professional. Therapeutic relationships differ from social and intimate relationships in that the nurse focuses on maximizing skills to enhance the client's growth. Key components of therapeutic relationships include establishing rapport, demonstrating empathy, showing warmth, and being genuine. Nurses have ethical responsibilities to respect clients' autonomy, beneficence, veracity and dignity.

1. THERAPEUTIC
RELATIONSHIPS

2. INTRODUCTION
A relationship is defined as a state of being related or a state of
affinity between two individuals. The nurse and client
interact with each other in the health care system with the goal
of assisting the client to use personal resources to meet his or
her unique needs.
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. The
interaction is purposefully established, maintained and carried
out with the anticipated outcome of helping the client gain new
coping and adaptation skills.

3. DEFINITION
Therapeutic relationship is defined as an
interactive relationship with a patient and
family that is caring , clear, boundaried,
positive and professional.

4. TYPES OF RELATIONSHIP
• Social relationships.
• Intimate relationships.
• Therapeutic relationships

5. CONTINUED….
• Social Relationships
A social relationship can be defined as a
relationship that is primarily initiated with the
purpose of friendship, socialization, enjoyment
or accomplishing a task. Mutual needs are met
during social interaction. For example,
participants share ideas, feelings and
experiences.

6. CONTINUED…
• Intimate Relationships
An intimate relationship occurs between two
individuals who have an emotional
commitment to each other. Those in an
intimate relationship usually react naturally
with each other. Often the relationship is a
partnership wherein each member cares
about the other's need for growth and
satisfaction.

7. CONTINUED….
• Therapeutic Relationships
The therapeutic relationship between nurse and
client differs from both a social and an intimate
relationship in that the nurse maximizes inner
communication skills, understanding of human
behavior and personal strengths, in order to
enhance the client's growth. The focus of the
relationship is on the client's ideas, experiences
and feelings.

8. GOALS OF THERAPEUTIC
RELATIONSHIP
o Facilitating communication of distressing thoughts and
feelings.
o Assisting the client with problem solving.
o Helping clients examine self-defeating behaviors and test
alternatives.
o Promoting self-care and independence

9. COMPONENTS OF THERAPEUTIC
RELATIONSHIP
Rapport
Rapport is a relationship or communication especially
when useful and harmonious. It is the crux of a
therapeutic relationship between the nurse and the
patient.
It is:
• a willingness to become involved with another person
• growth towards mutual acceptance and understanding
of individuality
• the end result of one's care and concern for another.

10. CONTINUED…
• The nurse establishes rapport through demonstration
of understanding, warmth and nonjudgmental
attitude. A skilled nurse will be able to establish
rapport that will alleviate the patient's problems.
When rapport develops, the patient Feels comfortable
with the nurse and find sit easier to self-disclose. The
nurse also feels comfortable and recognizes that an
interpersonal bond or alliance is developing.

11. CONTINUED…
• Empathy
Empathy is an ability to feel with the patient while
retaining the ability to critically analyze the situation. It
is the ability to put oneself in another person's
circumstances and feelings. The nurse need not
necessarily have to experience it, but has to be able to
imagine the feelings associated with the experience. In
empathy process the nurse receives information from
the patient with an open, nonjudgmental acceptance,
and communicates this understanding of the experience
and feelings so that the patient feels understood. This
serves as a basis for the relationship.

12. CONTINUED….
• Sympathy is often confused with empathy. In sympathy, the
nurse actually feels what the patient feels but in the process
objectivity is lost, and the nurse becomes focused on relief of
personal distress rather than on assisting the patient to resolve
the problem. With empathy while understanding the patient's
thoughts and feelings, the nurse is able to maintain sufficient
objectivity to allow the patient to achieve problem resolution
with minimal assistance.

13. CONTINUED…..
• Warmth
Warmth is the ability to help the client feel
cared for and comfortable. It shows acceptance
of the client as a unique individual. It involves
a non-possessive caring for the client as a
person and a willingness to share the client's
joys and Sorrow.

14. CONTINUED…
• Genuineness
Genuineness involves being one's own self . This implies
that the nurse is aware of her thoughts, feelings, values
and their relevance in the immediate interaction with a
client. The nurse's response to the client is sincere and
reflects her internal response. It is also important that the
nurse's verbal and non-verbal communication
correspondence with each other.

15. ETHICS AND RESPONSIBILTIES OF
NURSE –PARIENT RELATIONSHIPS
Ethics has been defined as a branch of philosophy that refers To
the study of values that conform to the moral standards of a
profession. The American nurses association has identified
four primary principles to guide ethical decisions. Governing
the relationship between the nurse and the patients, these
principles include the
• patient’s right to autonomy(making the decisions for oneself),
• the patient’s right to beneficence (doing good by the nurse),
• the patient’s right to veracity (honest) and truth by the nurse,
regarding the patient’s condition and treatment.
• Nurses respect for the patient’s dignity, autonomy, cultural
beliefs, and privacy is particular concern in psychiatric mental
health nursing practice.

16. CONTINUED….
• The nurse serves as an advocate for the patient and is
obliged to demonstrate non-judgmental and non
discriminatory attitudes and behaviors that are sensitive to
patient diversity. An essential are sensitive to patient
diversity. An essential aspect of the patient’s response is
the right to exercise personal choice about participation in
proposed treatments. The responsible use of the nurse’s
authority respects the patient’s freedom to choose among
existing alternatives and facilitates awareness of resources
available to assist with decision making.

17. CONTINUED….
• Nurses working with psychiatric mental health patients
are prepared to recognize the special nature of the
provider – patient relationship and take steps to assure
therapeutic relationships are conducted in a manner that
adheres to the mandates stipulated in the ANA code for
Nurses (ANA 1985). Unethical behavior(e.g. omission of
informed consent, breach of confidentiality, undue
coercion, boundary infringement ) and illegal acts can
increase the patient’s vulnerability and demand special
vigilance on the part of the psychiatric-mental health
nurse.

18. CONCLUSION
In conclusion an effective therapeutic relationship is
accomplished by good verbal and non verbal
communication. Respecting individuality, beliefs, values,
this promotes good recovery and openness between nurse
and patient.

19. RECAPTUALIZATION
• Therapeutic relationships
• Types of relationship
• Component of therapeutic relationship
• Ethics and responsibility of therapeutic relationship

20. ASSIGNMENT
Write an assignment on components of nurse-
patient relationship, and types of relationship.

21. BIBLIOGRAPHY
• K P Neeraja “ Essentials of mental health and
Psychiatric Nursing” Published by Jaypee.
• R Shreevani “ A guide to mental health &
Psychiatric Nursing” Published by Jaypee.

22. THANK YOU