persentation Prof.Dr. Sayneya M.Risk Dean Faculty of Nursing

1. persentation Prof.Dr. Sayneya M.Risk Dean Faculty of Nursing

2. Communication

3. Learning Objectives • Define Communication and its function. • Identify the Seven Basic Parts of the Communication process. • Explain Principles of Communication. • Describe four Barriers to effective Communication. • Describe four barriers to effective communication. • Identify three sets of skills necessary for effective communication. • Discuss factors influencing communication. • List ten helpful tips for therapeutic communication.

4. 9. Define interviewing and the steps of planning it. 10.Identify the techniques used in obtaining information gathering skills in interviewing adolescents. 11.Demonstrate the effective use of information gathering skills in interviewing adolescents. 12. Define counseling, ,its importance and it’s elements 13.Describe the characteristics of effective counselors. 14. use active listening and effective questioning skills in counseling adolescents. 15.Follow the steps of counseling technique through gather model in counseling adolescents.

5. Basic Principals of Communication Most People spend about 70% of their waking hours communicating speaking, reading or writing. Yet the quality of people’s communication is not effective communication can lead to misunderstanding. Poor performance, interpersonal conflict, and many other undesirable outcomes. To communication, people must “ construct shared realities-create shared meanings” in other words, they must engage in an exchange that is both understood and meaningful.

6. Definition of Communication Communication means transfer meaning and enhance understanding. It provides a two- way flow of information and includes sending and receiving messages.

7. Functions of Communication • Provides information • Enhances decision- making • Facilitates expression of feeling. • Promotes closer working

8. Communication Process • Message • Sender • Receiver • Encoding • Channel • Decoding • Feed Back Loop

9. Massage Massage Massage Massage Sender Encoding Channel Decoding Receivers Feedback Loop

10. Principle of communication • One Can Not Communication • No matter what happens in any communication interaction, some form of communication is taking, place. • Activity, inactivity or even silence can convey a message. • Once a message is sent, it is impossible to retract it.

11. Each communication has A content and Relationship Aspect • Communication not only conveys information (content) but it also imposes behavior (relationship). • How we communication depends not only on what we say, but how we relate to the person we are communicating with.

12. A series of communications can be viewed as an uninterrupted sequence of exchanges • Communication is a continuous, circular process. • It is a dynamic process in which messages are sent and received. • The content of the channels open and the communication continuous and uninterrupted.

13. Types of Communication

14. One- way Communication • The flow of information is in one direction. (sender controls situation) • It is quick, uncomplicated. • Little, if any response is expected from the receiver. • Very structured. • It does not allow the sender of communication to know if the message has been accurately understood • It does not allow the sender of communication to know if the message has been accurately understood. • It tends to inhibit questions from the recipient until the very end of the communication.

15. Example One- way Communication • Public speeches. Memo, and may university lectures. • She or he can present information in an organized manner and usually can outline his or her talk or communication before it takes place. • Television and radio are the two most common forms of public one-way communication in our culture.

16. Two- way Communication • The “ recipient” becomes actively involved in the communication process, giving responses immediately to the message sender, who in turn can modify the next message based on the other’s response or “feedback”. • It is slower than one-way communication. • It requires listening and flexibility on the part of the message sender. • It is generally more effective than one-way communication. • Sender and receiver contribute equally. • Feedback is expected and respected. • Unstructured – flexibility allows for dynamic exchange.

17. Communication Barriers

18. Selective Perception • Receivers interpret a message through their own perception. • Perceptions are influenced by their own experience, interests, values, motivations and expectations. • They might minter pert meaning from the sender’s original intent.

19. Language Barriers: • People interpret the meaning of wards differently, depending on many variables such as age, education, cultural back-ground, and primary • Using unfamiliar terms is a barrier to communication.

20. Filtering information • Means manipulation of information by the sender to influence the receiver's response. • Senders sometimes say what they believe receivers want to hear rather than the whole truth.

21. Emotional influence • How a person feels at the time a message is sent or received influences it’s meaning. • Senders can distort messages and receivers can interpret message incorrectly when emotions cloud their perception. • Emotions can interfere with rational and objective reasoning thus blocking communication.

22. Basic Communication skill

23. Sending skills • Self-Awareness: The sender should be aware of this feeling if he is anxious angry, tired, impatient …etc. • Awareness about the Receiver: • The message should be aware of the receiver's needs. • The message should suit, receiver's cultural background and level of understanding. • The message has signification for receiver. • How is receiver responding, as the health provider sends the message.

24. c. Message are sent through verbal and nonverbal channels: • Nonverbal messages. • Verbal message. • Effecting sending.

25. Receiving skills Receiving skills involve not only listening to what people say but also observing their behavior: • They enable people to receive accurate and complete message. • Effective receiving skills require attention to nonverbal as well as verbal message and seeking feedback to understand their meaning.

26. Skills needed for effective receiving are: • Active listening (reflective listening). • The skill of assuming responsibility for and understanding. • The feelings and thoughts in a sender’s message. • To be an active listener you should demonstrate interest by: • Sitting forward • Sustaining eye contact • Nodding the head • Asking occasional quest ional for clarification

27. Active listening includes • Reflective questions • Communication acceptance and increase trust. • Exercise problem-solving skills.

28. Interpersonal skills a. Showing respect showing respect means conveying the attitude that people have importance, dignity, and worth e.g. using the title of “MR” or “Mrs” b. Empathizing Empathy is the ability to communicate understanding and experience of feelings and reduces their anxiety and defensiveness. • It focuses attention on receivers and their feelings and reduces their anxiety and defensiveness. • It show that the sender shares peoples concerns, and make them feel that their contributions are valued.

29. c. Developing trust Trust developed through an open, honest and patient approach with others: • As trust develops, communication becomes more free flowing and productive. • Receivers will not express their true feelings if they do not fully trust the sender. • Health care providers develop trust in communication process by showing that they truly accept others, that they believe in them as people. • “Trust generates trust” e.g. if you show confidence in people you communicate with, they will respond the same way. • Treating people as fully participating partners in the communication process, and demonstrating that they are trustworthy and resposible.

30. Factors influencing communication Effective communication , both sending and receiving is strongly influenced by three factors: • Pervious Experience • Culture • Relationship

31. Helpful Tips for therapeutic Communication • Use broad opening statements to open communication (How have you been feeling?). • Listen carefully, eagerly, actively, responsively, and seriously to what client. • A knowledge client without inserting your own values or judgments. (I hear what you are saying). • Use feedback to relay to client the effect of his or her words. (you did that well?). • Being congruence , the harmony or verbal messages (A client is crying, health providers says “I want to help” and puts his hand on the client’s shoulders) • Clarify clients’ message (you said it was hot in here. Would you like to open the widow?)

32. Focus or refocus on client’s statement (You were telling me how hard it was to talk to your mother) • Validate accuracy of client’s message. (Yes it is confusing with so many people around ) • Identify and send back a message acknowledging the feeling expressed ( reflection) (You distrust your doctor). • Ask client open ended question( what kind of job would you like to do?) • Give client encouragement through use of nonverbal action (Nods appropriately as someone talks)

33. Restate the last few wards the client says. • Paraphrase or reward what client has said? ( you mean you are unhappy) • Show interest and involvement without saying anything else. (Yes ….uh hm) • Use incomplete sentence to encourage client to continue. (Then your life is….). • Keep your own verbalization minimal and let the client lead feel…..?)

34. Interviewing and Couseling

35. Planning the interview • Determine the purpose of the interview. • Provide a safe, private, comfortable setting if possible. • Both the health provider and client will agree to conduct the interview. • Determine the time to complete planed process or goal of interview.

36. The Techniques used to Obtain Information includes • Asking Open – Ended Questions It allows the client to describe an issue, a feeling or problem in his own words, giving as much or as little information as they wish. (How are you today?) On the other hand the closed indeed question needs only a one word answer: (What is your age?)

37. Focusing It limits the area to which the client can respond but still encourages more than a yes or no type of answer.( You only mentioned your family briefly could you tell me more about them) • Probing It is any question or statement used to pursue further detail about an area (tell me more.) (is there anything you left out?)

38. Paraphrasing • It is giving back the clients meaning of a phrase sentence in your own words. • It gives the client the opportunity to verify interviewer “ translation” and to think further about the matter at hand. • Clarifying • It is used when the client say or do something that the interviewer does not understand . (I am not sure I understand that completely could you repeat it?)

39. Testing discrepancies • Incongruity of Message : refers to an inconsistency between the words, toner, gestures, and body language of the client in a single message, (A male client with tears in his eyes may deny his feeling by saying “I feel fine”) • Conflict of information : means that the data presented by the client at one moment in time differs from that presented at another.

40. Exploring personal Health Related Habits • An atmosphere of trust should be established before exploring any sensitive personal areas as issue of smoking, sex, or drug use…etc. • The interviewer should convey( by manners, posture, voice …etc) that anything the client says or does in Reponses to these questions is “ok”. • A sense of unconditional acceptance for the client will yield much more useful information in these areas than judgmental, anxious, anxious, or moralizing manner. • Open –ended or focused questions can be used to begin, followed by probes ,requests for clarification and summation. • Once an atmosphere of trust and acceptance has been established, asking questions about these personal issues is like talking about any other topic (have you ever used drugs?)

41. Pitfalls of interviewing ( common ways of hindering communication- don’t do) • Do not give advice. • Do not change the subject. • Avoid responding in a way that focuses attention on you. • Avoid internal validation ( Jumping to conclusion). • Do not validate client's words by ignoring or denying his presence though, or feelings. • Avoid giving false reassurance.

42. Avoid value judgment . • Avoid being incongruent. • Avoid long periods of silence. • Do not use contradicting verbal and nonverbal messages. • Avoid blaming the client. • Do not defensive. • Do not provide leading statements (put words in the client mouth). • Do not over use of closed ended questions.

43. Counseling • Definition Counseling is a two-way process through which the provider helps the client makes informed decisions. It helps the client explore his needs and concerns. It also helps him clarify, define, discuss and understand his feelings, makes his own decisions, and resolves his own problems. It is a process through which an individual with especial knowledge and/or skills interacts with a client. It could also be defined as a one to one consultation that is intended to enable the client to make the best choices.

44. Importance of counseling • It helps to establish a trusting relationship. • It helps clients make informed choices and decision. • It supports correct actions. • It helps clients understand what to do in order to maintain their health.

45. Elements of counseling • Counseling involves a basic acceptance of the client’s perception and feeling. • Counseling involves responding to the feelings, and actions of the client. • Confidentiality and privacy constitute essential aspect in the counseling setting. • Counseling is voluntary; it is not effective when it is something that the client is required to do. • Awareness of and sensitivity to the kinds of messages being communicated is an important prerequisite for counselor effectiveness. • Counseling is a cross-cultural experience.

46. Characteristics of effective counselor • Self-awareness and understanding: • Good personal health: • Sensitivity to and understand of cultural factors in self and other: • Open-mindedness • Objectivity: • Competence: • Trust worthiness: • Interpersonal attractiveness

47. Skills used in counseling • Developing listening and learning skills Listening actively • Meet with clients in a private, comfortable place. • Accept clients as they are. • Listen to what clients say and how they say it; notice of voice, choice of words, facial expressional and gestures. • Put yourself in the client’s place as he or she talks • Sit comfortably, avoid distracting movement, and look directly at your client. (make eye contact ).

48. Be attentive. Use verbal and nonverbal messages effectively • Use silence appropriately. • Move at the client’s pace. Give time to think and ask questions. • Listen to your client carefully of thinking what you are going to say next.

49. Use paraphrasing to make sure you understood what your client wants to say, and it will also assure the client that are listening • Every now and then repeat what heard, and then both you and your client know whether you have understood from what have been said.

50. Questioning effectively • Use a tone of voice that shows interest, concern and friendliness. • Maintain eye contact: • Ask only question at a time. Wait for an answer. • Ask questions that let clients talk about themselves • Begin by asking open-ended question. • Follow with closed questions.