What are the strategies of therapeutic communication?

Reviewed by Nicole Iannelli

Table of Contents Show

What are some therapeutic communication techniques?
How can nurses improve therapeutic communication?
How does Therapeutic Communication in nursing practice improve patient safety?
Therapeutic Communication for Patient Care
Purposes of Therapeutic Communication Techniques
17 Therapeutic Communication Techniques
Conclusions

The importance of effective communication in nursing goes far beyond speaking to your patient about their care. As a nurse, you are also responsible for communicating with patients in a therapeutic way. But, what does this mean?

Effective therapeutic communication is a way to improve nurse-patient interaction, as well as build trust between the registered nurse and their patients. Nurses are meant to provide patients with that support and information while they are maintaining a professional distance and objectivity. Open-ended statements and questions are often used to help patients work through situations under the guidance of the clinical team. So, before sending your application to different travel nursing agencies, let’s brush up on effective therapeutic communication techniques.

What are some therapeutic communication techniques?

There are 12 therapeutic communication techniques that every nurse should know. The following techniques can help you improve your communication with patients:

Use silence: Deliberate silence is a communication technique that can be exactly what is necessary for a stressful situation. This will provide the team the opportunity to comprehend a topic before moving on to the next.
Accepting: Listening and affirming that you have heard your patient is necessary for inpatient care. Keeping eye contact and a simple “yes, I understand” can go a long way. It makes your patients feel heard and in control of their care.
Affirm desired behaviors: Letting your patients know that you are aware of their efforts and acknowledgment of positive behaviors can go a long way. Rather than giving a compliment, giving recognition is more suitable.
Offering self: Hospital stays can be stressful and lonely at times for patients. Nurses offering up their time shows that they care and value their patients. Simply offering to stay for lunch or simply sitting with patients can boost their mood.
Ask open-ended questions: By asking open-ended questions, you are able to capture your patient’s thoughts and perceptions.
Active listening: Active listening is vital for effective communication. Simply maintaining eye contact or keeping the conversation moving with an “I hear you” shows the patients that you do care and are listening when they speak.
Seeking clarification: When communicating with a patient or patients’ family, you can ask for clarification when a topic is confusing. This, along with active listening is vital to an open line of communication between the nurse and the patient.
Placing the event in time or sequence: Getting a clearer sense of the whole picture can help with a care plan. Putting events in a sequence of when they happened in relation to others can be very important.
Share thoughts and observations: This proves to your patient that you are paying attention and encourages patients to keep sharing.
Read body cues: Pay attention to the patient’s body language, a simple smile can show that your patient understands what you are saying.
Recognize, acknowledge and accept: It is vital that patients feel respected and understood. Allowing patients to feel empowered can assist in building a positive nurse-client relationship.
Offering hope and humor: Sharing hope with patients can preserve a patient’s emotional status while they are in the hospital. Lightening the mood with humor can help keep patients in a positive state of mind.

How can nurses improve therapeutic communication?

Communication is key in the healthcare field, especially for nurses. As a nurse today, you are required to have exceptional communication skills in addition to clinical skills. Today’s nurses must be able to effectively communicate with doctors, other nurses, patients, and families, all while juggling the stressful demands of a clinical setting.

There is always room to grow your therapeutic communication skills. In our latest blog, we outlined ways you can improve your effective communication. While this is important in the clinical setting, therapeutic communication is more important for overall patient care. So, looking at how to improve therapeutic communication in nursing?

Here are a few ways you can improve your therapeutic communication skills as a nurse:

Improve Your Body Language
Become a Better Listener
Avoid Interruptions
Exercise Patients
Maintain Positive Attitude
Keep Emotions in Check

How does Therapeutic Communication in nursing practice improve patient safety?

What is the importance of therapeutic communication in nursing? Patient safety is one of the most important aspects of nursing. While in a hospital or skilled nursing, the nurse is responsible for ensuring patient safety. The key to this is an open line of communication.

Communication is the cornerstone of healthcare, and the way in which items are conveyed can impact overall patient care. When communicating with your co-workers, it should be done in an effective way with verbal, non-verbal, and written skills. It is vital that you are providing information as thoroughly as possible. However, when you are communicating with patients, this needs to be done in an honest and therapeutic way. This helps ease some of the stress for patients while they are in treatment.

Some studies have shown that when clinicians communicate effectively, they are able to provide a safer and higher quality of care. Additionally, when nursing managers have an open door policy it can lead to a better work environment and a more positive moral. This can also lead to an overall more positive patient experience.

Therapeutic Communication for Patient Care

Using the right therapeutic communication technique is key to the success of patient care. Techniques that every nurse already knows can be expanded upon to help build trust between fellow nurses, doctors, and patients.

Ready to apply these therapeutic communication techniques? Speak with our team of recruiters today to learn about all of the locations our nurses are currently working in.

Reviewed By:

Nicole Iannelli, Human Resources Administrator– Nicole has worked for MAS Medical Staffing for over a year. She has 3 children and is recently engaged. While Nicole is not working, she loves hanging out with her family and friends.

References:

By TigerConnect on April 15, 2020

Therapeutic communication techniques are a standard part of nurse and therapist training. That makes sense, because:

Given all the time nurses and therapists spend with patients, these clinicians are in the best position to:

Help patients understand and accept what’s happening clinically
Monitor patients’ progress
Influence patients to make the best decisions for themselves
Help forge the best path to physical and emotional healing

To do all that for their patients, nurses and therapists must understand and use the best therapeutic communication techniques.

Purposes of Therapeutic Communication Techniques

Before we look at any therapeutic communication techniques, we should understand why a nurse or therapist ought to bother with them. Because frankly, they’re hard work.

Let’s say you’re a nurse, and you want to help a patient get well. You could simply tend to tasks like changing sheets, taking vitals, bringing meds, and helping the patient to the bathroom.

But that would be basic patient care. You want to provide quality care.

Quality care goes beyond just completing tasks for your patient. Quality care means interacting with your patient to learn how their healing is progressing, then tailoring your behavior to suit the unique physical and emotional needs of your patient, at that moment.

And that’s where therapeutic communication comes in.

“Therapeutic communication is an interpersonal interaction between the nurse and the client during which the nurse focuses on the client’s specific needs to promote an effective exchange of information. Skilled use of therapeutic communication techniques helps the nurse understand and empathize with the client’s experience.” – Nurseslabs.com

“Therapeutic communication is essential to the use of the self as an instrument of healing. It is the use of verbal and non-verbal messages to establish a professional therapeutic nurse-client relationship that will be the context for meeting the client’s physical and psychological needs.” – Therapeutic Interaction in Nursing (book)

By using therapeutic communication methods, a nurse can respectfully and compassionately lead a patient to share the most pertinent information about:

Their physical, mental, and emotional health
Their needs
The effectiveness of treatments

The healing process for most patients involves a collection of clinical tests and treatments. But for many patients, therapeutic communication contributes just as much to their overall healing.

You can think of it like this: Clinical tests look at physical attributes to assess the organs, structure, and systems of the physical body, and clinical treatments seek to fix problems found by the tests.

Therapeutic communication combines testing and treatment in a single process. It uses observation and empathic skills to assess and manage the patient’s emotions, determination, feelings, and attitude – their spirit and soul.

The purpose of therapeutic communication, then, is to help clinicians build trust with patients while also helping clinicians and patients collaborate efficiently and effectively toward the patient’s physical and emotional wellness.

17 Therapeutic Communication Techniques

In some interactions with patients, clinicians are simply being friendly. But in many interactions, clinicians are trying to achieve a clinical objective. Therapeutic communication techniques play a leading role in reaching the clinical objective.

To get maximum effectiveness from therapeutic communication techniques, clinicians should follow three steps:

Catch cues from the patient. Is he calm and confident? Anxious and agitated? Eager and enthusiastic? Confused or clear-headed? Frustrated?
Choose a technique that will likely support a positive discussion under the current circumstances.
Fortify your words with intentional body language:

- Make and keep eye contact
- Sit if necessary, so your eyes are close to the same height as your patient’s eyes
- Square your shoulders toward your patient
- Focus all your attention on the patient (no multitasking)
- Speak in a conversational speed and tone
- Avoid postures, gestures, and facial expressions that suggest apathy, impatience, or judgment

TECHNIQUE	REASON TO USE	EXAMPLE
Affirm desired behaviors	Let your patient know that you’re aware of her efforts. This recognition acknowledgment is not framed as a compliment because a compliment for doing a basic task (like going to the bathroom by herself) can be perceived as condescending.	“I see you’re wearing the blouse your daughter brought yesterday.”
Ask for clarification	You’re not confident you understand your patient correctly due to certain ambiguous words, gestures, or body language.	“I’m not sure I got that. What did you mean by ‘everything is different now?'”
Ask open-ended questions	Helps you capture your patient’s thoughts and perceptions while also assessing his attitude, awareness, and thinking abilities.	“Tell me more about that.” “How do you cope with that?”
Confront	You’ve established trust with your patient, and now you observe him saying or doing something inconsistent with an attitude, belief, or behavior he expressed earlier. Gently help him see the contradiction so you can help him align what he’s doing with what the results he wants.	“Mr. Jones, you said you wanted to get back to your family as fast as possible, but you’ve been in bed all morning. Will you be ready to walk the hallway in the next half hour?”
Encourage formulation of an action plan	Your patient needs to break a bad habit or create a good habit.	“What are some steps you think you could take to help you limit the number of donuts you eat?”
Focus	Your patient is jumping from topic to topic without closure on anything. You need her to focus on one key area so you can capture critical details and so she isn’t overwhelmed by everything at once.	“You’ve brought up several good points. Let’s get back to what you said about sometimes forgetting if you took your medicine.”
Give information	Builds trust, reduces patient anxiety, and improves patient cooperation and safety because she understands what’s happening and why it’s happening and is therefore more likely to comply.	“After the surgery, you’ll have a drainage tube in your neck. You’ll need to change the surrounding bandage every 6 hours, then come back in three days to have it removed.”
Make broad opening remarks	Gives your patient the freedom to talk about what she wants to talk about. She has some control over circumstances and is not just a problem to be fixed.	“What’s on your mind today?” “Where should we start?”
Offer your time and presence	Builds trust by demonstrating you care about and are interested in your patient.	“Is it ok if I sit with you until patient transport arrives?”
Place events in sequence	You need to understand what may have caused specific symptoms, and your patient should become aware of connections between his actions and his symptoms.	“Did you experience the light-headedness before or after you got up to leave the theater?”
Reflect	Your patient asks for advice, and you show respect for her judgment and encourage self-accountability by asking the question right back.	Patient: “Do you think I should tell my family physician?” You: “Do you think you should?”
Restate / paraphrase	Assures your patient you heard and understood what he said.	Patient: “This food tastes like cardboard.” You: “Not enough flavor for you?”
Share thoughts and observations	Shows your patient you are paying attention and encourages her to share more information.	“That must have been unpleasant.” “You seem more tired today.”
Suggest comparisons	You need to convert a patient’s vague or abstract experience into something understandable.	“Does it feel like pins and needles pressing against your fingertips, or more like a pencil eraser?”
Summarize	You or your patient provided a lot of information. You need to confirm a shared understanding and bring closure to the discussion so you can document accurately.	“Ok, so we agreed you’ll press the call button next time you either feel that pain in your arm or feel like it’s more difficult to breathe.”
Use active listening	Builds trust by showing your patient that what she’s saying is important to you. She knows you are paying attention and feels like it’s safe to keep going. It also contributes to mental and emotional healing.	Make and hold eye contact. Turn to face your patient. Nod in agreement. Don’t multitask. “Ok, I’m with you.” “Oh my.”
Use silence	Your patient needs time to collect and organize his thoughts and decide what to say next.	Retain eye contact. Continue to face your patient so he knows you’re ready for him to continue. Allow your patient to speak next.

When a clinician is skillful with therapeutic communications, they can develop a therapeutic relationship with their patient. Through that relationship, the clinician becomes more effective at recognizing and influencing meaningful changes in the patient’s physical, mental, and emotional state.

And remember, therapeutic communications are not restricted to face-to-face encounters. Technology brings more opportunities to use therapeutic communication techniques.

We’ve been using phones and email for years. More recent developments allow clinicians and patients to connect via secure texting and video conferencing. These technologies are especially helpful for patients with chronic conditions that require routine monitoring, and also for post-op patients who need follow-up care. Clinicians can build and strengthen their relationship by using these technologies to more frequently apply their therapeutic communication skills — even when patients have left the hospital or clinic.

Conclusions

According to the American Psychiatric Nurses Association, therapeutic communications are marked by “an attitude of respect, dignity, and empowerment.”

Sure, it’s a challenge. Nurses and therapists are asked to be always “on” and ready to pour their best mental and emotional energy into their communications while simultaneously offering their best clinical knowledge and skills.

But the rewards are massive. When nurses and therapists take their valuable clinical training and skills, add targeted therapeutic communication techniques, and take advantage of new ways to bring patients into the conversation, then we and the people we care about receive better care with fewer missteps, and our healing is faster and more complete.

Tags: therapeutic communication, nurse client relationship, active listening, therapeutic relationship, communication techniques, encourage the client, eye contact, recognition acknowledgment, therapeutic communication techniques