Ghapter

Skillful use of quesdons helps guide clients through the

gxmblem-solving process. Clients become empowered as they
r* from siruations they have encountered. Questions also
'Mp ciients assume responsibility for their own actions.

#sctJitating Techniques Effective communication techxr,Qses communicate your listening, understanding, and

lllness Management: Communication and Psychoeducation

133

caring. The nurse must analyze the behavioral, affective,

and cognitive components of communication in order

to

respond to overt and covert messages. Effective

communication also encourages clients to examine feelings, explore problems in more depth, build on existing
strengths, and develop new coping srrategies (see
Table 7.4 w).

Etfective: Communioalion Techniques

Mlnique

Examples

@ad

"What would you like to work on today?"

opening

"What is one of the best things that happened to you this week?"
,Sving recognition

"l notice you're wearing a new dress. You look very nice."
"What a marvelous afghan that is going to be when you finish."

' *.inimal encouragement

"Uh-huh."

,.

"Go on."

"Ummm."

a.

,@ng

self

\itl
$\)

"l'll sit with you until it's time for your family session."
"l have at least 30 minutes I can spend with you right now."
"l can imagine how that might feel."
"l'm with you on that lnodding]."

{ffiing observations

"Mr. Flobinson, you seem on edge. You are clenching your fi$t and grinding your teeth."
'm OuzzteO, You're smiling, but you soun-d so

b@idating perceptions

"This is what I heard you say. . . . ls that correct?"

"lt sounds like you are talkinO abgut sad
ls tha-t colect?"
leelinOs.
"How does your girlfriend feel about your being in the hospital?"
"Tell me about what was happening at home just before you came in the hospital,"

"Could you explain more about that to me?"

"l'm having some difficulty. Could you help me understand?"

F$acing the event in time or

"Which camefirst. . . ?"

sequence

"When did Vou ffrst

lotice

Rt
Y

tr
as

r(u

\(

. . . ?"

i-ocustng

"Could we continue talking about you and your dad right now?"
"Rather than talking about what your husband thinks, I would like to hear how you're feeling
right now."

Encouraging the formuiation

of a plan of action

"What do you think you can do the next time you feel that way?"

Suggesting collaboration

"Perhaps together we can figure out. . . ."

'Lett try using thy groblel-solving process tha]

\h

AA
G\
o9
o '--

s,

1as

pres:lled

ln

group yesterday."

Client: "Do you think going home will be difficult?"

Nurse; "How difficult do you think going home will Oe?"

Reflection

Client: keep thinking about what all my friends are doing righi now."
Nurse: "You're worried that they aren't missing you?"

Client: "He laughed at me. My boss just sat there and laughed at me. I felt like such a fool."
Nurse: "You felt humiliated?"
"So far

*"

vr

*a

"How might you handle y?ur anger in a nonthreltening way?"

Bestatement

Summarizing

lf a)
:CJ

lesentful l

f;hrifying

,T}

frare talked about . . . ."

"Our time is up. Let's see, we have discussed your family problems, their effect on your
schoolwork, and your need to find a way to decrease family conflict,"

\<

Yo

1i
xE
sS
q)

L^

s
,:b

\\

ss-

N.

135

Unit

lllness Management and Recovery

lneffective 0ommunication Techniques

TecinlOue

Elam0les

Stereotypical comments

"What's the mater, cat got your tongue?"

'Still

Parroting

run

"

-waters
-deep,
Client: "l'm so sad."
Nurse: "You're so sad."

Changing the topic

Client: "lwas so afraid I was going to have another panic attack."

Nursel "What does your husband think about your p_anic attacks?"

Disagreeing

"l don't see any reason for you to feel that way."
"No, I think that is a silly response to your mother."

Challenging

"ts tnat a valid reason to become angry?"

"You weren't really serious, were you?"

Requesting an explanation

"Why did you react that way?"

wfv canJ vou i11s]
home?

False reassurance

"Don't worry anymore."

lea,ve

'l doubt
Belittling expressed feelings

tlat youl mother wifl be anSV aboyt

your faillng math "

"That was four years ago. lt shouldn't bother you now."

"You shouldn't feel that all men are bad."

'lt's
Probing

w-rone

to

even think of your mother like that "

"l'm here to listen. I can't help you if you won't tell me everything."
"Tell me what secrets you keep from your wife."

Advising

"You sound worried. I think you'd better talk to your doctor or your rabbi."
"! think Vou should divorce your husband:'

lmposing values

Client: [With head down and low tone of voice] "l was going to go on the cruise, but my mother is
coming to stay with me."
Nurse: "You must be lookfng forward to her arrival."

Double/multiple questions

"What makes you feel that you should stay? How would you get along if you left? Would you rent an
apartment or move in with a friend?"

The significance of nonuerbal cornrnunicatioa must always be considered. \flhen working with families or groups,
consider the following questions, and then interpret the significance of the answers:

r How close together do people sit?

r Are some members physically isolated from others?
r Can each person see the other members fairly easily?
r Do members look at the person who is speaking?
r Do members behave in a distracting manner while a
person is speaking?

How is touch used within the group?

r Are nonverbal

behaviors directed toward a particular

member or the entire group?

How do facial expressions change throughout the interaction?

\il/hat kinds of gestures are used?

Are there changes in voice tone?

Another consideradon is the significance of uerbal communication. Consider the following questions, and interpret
the significance of the answers:

r Is somebody refusing to talk?

r \7ho speaks to whom, about what, and when?
r Are there individuals who are speaking for others?
r \X/ho interrupts others?
r 'Who is tdkative?

\(ho
lVho

contributes little?

r
asks questionsi
r 'W'ho gives the answers?
r \ilho gives opinions?