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Chapter 4

Chapter 4. Therapeutic Communication Skills. Importance of Communication. Foundation for all patient care Therapeutic communication skills create feelings of comfort for patients. The Communication Cycle. Involves two or more individuals exchanging information

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Chapter 4

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  1. Chapter 4 Therapeutic Communication Skills

  2. Importance of Communication • Foundation for all patient care • Therapeutic communication skills create feelings of comfort for patients

  3. The Communication Cycle • Involves two or more individuals exchanging information • Involves sending and receiving messages

  4. The Communication Cycle ^^ The communication cycle and channels of communication.

  5. Four Elements ofthe Communication Cycle • The sender begins cycle by encoding message • The message delivered via a channel or mode of communication • Speaking • Listening • Gestures or body language • Writing

  6. Four Elements ofthe Communication Cycle • The receiver must decode the meaning of the message • Feedback takes place after receiver has decoded message sent by sender

  7. The Communication Cycle • Listening skills • Active listening involves verifying message from sender • Received message is sent back to sender worded slightly differently

  8. Verbal Communication • Takes place when message is spoken • Sender and receiver must apply same meaning to spoken words

  9. Verbal Communication • The Five C’s of Communication: • Complete • Clear • Eye contact enhances clarity • Articulate and enunciate • Time to process message • Message must be heard • Concise • Cohesive • Courteous

  10. Verbal Communication • Good communication skills help establish rapport with patients • Call patients by full name • Encourage patients to verbalize feelings • Give technical information to patients clearly • Allow patients to make practical application to their health needs

  11. Nonverbal Communication • Body language • Unconscious body movements, gestures, and facial expressions Body language can communicate more than spoken words >>

  12. Nonverbal Communication • Body Language • Expressions that accompany speech • Kinesics is study of body language • Body language learned first • Body language influenced by primary caregivers and culture

  13. Nonverbal Communication • Feelings and emotions are communicated through nonverbal means • 70% of language is nonverbal • Tone of voice communicates 23% of message • Spoken word communicates 7% of message

  14. Nonverbal Communication • Facial expression • Eyes reflect feelings • Staring is invasion of privacy • Cultural influences affect facial expressions • Personal space • Comfortable personal space • Handled differently by various cultures • Explain procedures that will be invasive

  15. Nonverbal Communication • Posture • Relates to position of body or parts of body • Involves at least half the body • Position • Face-to-face communication • Should enable observation of verbal and nonverbal cues

  16. Nonverbal Communication Positive posture and position encourage therapeutic communication >>

  17. Nonverbal Communication • Gestures and mannerisms • “Talk” with hands • Enhances spoken word • Touch • Appropriate touch is therapeutic • Not all patients are comfortable with touch

  18. Congruency in Communication Click Here to play the video

  19. Congruency in Communication • Verbal and nonverbal messages must agree • The meaning of mixed messages • Clustering groups of nonverbal messages • Masking conceals true feeling or message

  20. Congruency in Communication • Perception • Conscious awareness of one’s own feelings and the feelings of others • Sense another’s attitudes, moods, and feelings • Follow perceived assessments with verbal validation • Easily misinterpreted

  21. Barriers to Therapeutic Communication • Age and gender barriers • Economic barriers • Education and life experience barriers

  22. Barriers to Therapeutic Communication • Bias and prejudice barriers • Verbal roadblocks to therapeutic communication

  23. Regression Denial Repression Projection Sublimation Displacement Compensation Rationalization Undoing Defense Mechanisms as Barriers

  24. Barriers to Therapeutic Communication • Barriers caused by cultural and religious diversity • Caregiving expectations • Time focus

  25. Barriers to Therapeutic Communication • Human needs as barriers to communication Maslow’s hierarchy of needs >>

  26. Establishing Multicultural Communication • The patient must trust the professional • Steps to building trust include: • Risk/trust • Conveying empathy • Showing respect • Being genuine • Active listening

  27. Working with Multicultural and Diverse Patient Populations Click Here to play the video

  28. Cultural Brokering • Cultural broker serves as a go-between • One who advocates on behalf of another individual or group within the health care community

  29. Cultural Brokering • Goal of cultural brokering • Increase the capacity of health care and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems • Cultural brokers may assume the role of medical interpreter

  30. Working with Interpreters • Interpreters do not provide word-for-word equivalence, rather focus on the accurate expression of equivalent meaning • Remember to speak directly to the patient, not to the interpreter

  31. Working with Interpreters • A family member may serve as the interpreter • Disadvantage of a family member serving as interpreter • They may not understand medical terminology • It would be very difficult for a family member to share a poor prognosis or a life-threatening diagnosis

  32. Interview Techniques • Closed questions • “Are you taking your medications?” • Open-ended questions • “How are you coming along with your diet?” • Indirect statements • “Tell me what you’ve been doing since your retirement.”

  33. Point of Care Techniques • Location where the patient and provider or patient and office personnel physically interact

  34. Community Resources • Need to refer patient to a community resource • Developing a community resource document

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