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Therapeutic Communication
• Therapeutic communication is defined as the
face-to-face process of interacting that focuses on
advancing the physical and emotional well-being
of a patient.

• Nurses use therapeutic communication  techniques

to provide support and information to patients.

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 Therapeutic Communication
• Therapeutic communication is “a process in
which the nurse consciously influences the
patient or helps them in better understanding
through verbal and nonverbal communication,
while encouraging patients to express their
feelings and ideas, which is an important
prerequisite for the realization of relation of
mutual acceptance and respect.

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 Critical Elements Of Effective
Therapeutic Communication
1. Be able to decipher the patient’s message.
2. Get to know the patient well enough to
discover the underlying meaning (intent) of
his/her communication. Be alert & perceptive
enough to pick up the correct message.
3. Many people feel uncomfortable talking about
their feelings, especially if they are trying to
be “good patients.” Learn to “read between
the lines.”

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 Critical Elements Of Effective
Therapeutic Communication
4. When communicating with patients, each
Practical Nurse has to find the ways that
are the most effective for the people and
circumstances concerned.
5. Be emotionally mature enough to postpone
the satisfaction of your own needs in
deference to the patient’s.

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 Critical Elements Of Effective
Therapeutic Communication
6. Be realistic in your relationships with
people; avoid making assumptions or
judgments about your patients’ behavior. If
you have negative thoughts about something a
patient says or does, try to keep in mind that
he is an adult, responsible for making his own
decisions.

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 Therapeutic Communication
Techniques
1. All communication must preserve the
self-respect of both individuals.
2. One should communicate
understanding before giving any
suggestions or advice. Activities are
carried out with the patient, not for the
patient.

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 Therapeutic Communication
Techniques
• OBSERVING & LISTENING SKILLS.
• LADDER
L = Look at others, keep good eye contact.
A = Ask appropriate questions only.
D = Do not interrupt.
D= Do not change the subject.
E = Express emotions with control.
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R= Responsively listen. 8
 TECHNIQUES OF
THERAPEUTIC
COMMUNICATION
Technique Description Example
Broad opening To allow the patient to pick the topic,  Where would you like to begin?
statements take the initiative to express self, and  What is on your mind today?
set the direction of the conversation.  What are you thinking about?
Note: there is no topic is given by the  Is there anything you would like to
student. The patient gives the topic in discuss?
response.
– Encouraging the client to select
topics for discussion. E.g.: What are
you thinking about?

Exploring Examines certain ideas, experiences, or  What kind of relationship do you

relationships more fully. have with your children?
 Tell me about your coping
mechanisms?
 What brought you here to the
hospital?
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 TECHNIQUES OF
THERAPEUTIC
COMMUNICATION
Focusing Helps the patient focus on a certain point 
when they are jumping from topic to
topic.
 You’ve mentioned many things.
The patient is talking about many things
at once and you focus in on one topic.
Questions or statements that help the
patient expand on a topic of importance. 
Silence Provides time for the patient to put
thoughts or feelings into words, regain
composure or continue talking.
Lack of communication for a therapeutic
reason. E.g.: Sitting with a client and non-
verbally communicating interest and
involvement
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Let’s stop and look more closely at
your feelings about managing your
medications.
Let’s go back to your thinking of
“giving up”.
“I think we should talk more about
your relationship with your Father.
“
Maintain an interested, expectant
silence.
(If you are silent because you are
uncomfortable or don’t know what to
say, then it’s a block and should
be processed as such.)
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 TECHNIQUES OF
THERAPEUTIC
COMMUNICATION
Acceptance Indicated the patient has been  Uh-hmm.
understood.  Yes.
It does not indicate agreement and  I’m following you.
is nonjudgmental.  Nodding.

Giving recognition Indicated awareness of change in Good morning, Mr. Jones. I see
personal efforts. Does not imply you have put on your jewellery
good or bad, right or wrong. today.
You’ve finished your list of things
to do.
Sharing Calls attention to the patient’s You appear tense.
observations physical behavior or emotional I noticed that you are biting your
state. How a person looks, sounds lip.
or acts? You seem upset.
Verbalizing what the nurse You are trembling.
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perceives
 TECHNIQUES OF
THERAPEUTIC
COMMUNICATION
Paraphrasing Repeating the main idea in
order to be sure the patient
has been understood.
Restating another’s message
more briefly using one’s own
words.
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- Patient: “I have been tossing & turning all
night.”
Nurse: “You are having difficulty
sleeping.”
- Patient: “I just give up.
” Nurse: “You don’t see the point of trying
anymore.”
- Patient: “I’ve been overweight all my life
and never had any problems. I can’t
understand why I need to be on a diet.”
Nurse: “You are not convinced that you
need a diet because you’ve stayed healthy.”
You say that your Mother left you when
you were 5 years old.
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 TECHNIQUES OF
THERAPEUTIC
COMMUNICATION
Makes facts available in order to  This medication is for you
Providing
assist in decision-making or high blood pressure.
information drawing conclusions.  This test will determine your
The skill of information sharing. treatment options.
   My purpose for being here
is…
 “I think you need to know
more about your medications”

Sharing Acknowledging feelings. To help Patient: “I hate it here. I wish I

the patient know that feelings are
Empathy understood and accepted.
Attempting to see the situation
through the client’s eyes.
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could go home.”
Nurse: “It must be difficult to stay
in a place you hate.”
This diagnosis has been life
changing.
You have a lot on your plate.
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 TECHNIQUES OF
THERAPEUTIC
Sharing humor
COMMUNICATION
Discharge of energy through comic enjoyment of This gives a whole new
the imperfect. Can reduce tension and promote meaning to “just relax”.
mental well-being.

The discharge of energy through the comic

enjoyment of the imperfect. That gives a whole
new meaning to the word ‘nervous’, said with
shared kidding between nurse and the patient.

Sharing hope Communicating a sense of possibility to achieve I believe you will find a way
their potential. Commenting on the positive to face your situation
aspects of the patient’s behavior, performance, because I have seen how you
and responses. interact with your children in
this situation
You must personally see the patient
display the behavior you base this hope on. It
can’t be based on things you did not observe
because that is a block called “false reassurance”.
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 TECHNIQUES OF
THERAPEUTIC
COMMUNICATION
Care must be taken to use touch at the Holding a patient’s
Using appropriate time and with the hand or placing your
Touch appropriate patient. Touch should not hand on a patient’s
be used when someone is paranoid, shoulder
angry, in a panic state, or has had
previous trauma. Sensitivity to
cultural and social cues for touch must
be practiced. Asking permission may
be appropriate in some cases.

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 NON-THERAPEUTIC
COMMUNICATION
Giving Advice/ Nurse imposes own opinion and What you should do is….
Personal solutions on the patient. Implies Why don’t you…?
Opinions the patient cannot make own Get out of that situation
decisions. immediately.
These are decisions that are not I would leave that person if they did
ours to make. that to me.
Asking personal Asking personal questions not Why have you never gotten
questions/probing relevant to the situation. These married?
questions may be asked due to What is your political party?
personal curiosity and not for the
client’s benefit.
False reassurance Attempts to dispel anxiety by Don’t worry, everything will be all
implying there is not sufficient right.
reason for concern. You’re doing fine.
I wouldn’t worry about that.
12/19/22 12:13 I’ve felt that way myself sometimes
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 NON-THERAPEUTIC
COMMUNICATION
Agreeing/ Implies right and wrong, good or That’s the right attitude.
bad from the nurse’s point of view. I agree.
Disagreeing Now, if the client changes their You must be right.
mind, they are “wrong”. Limits That’s not true.
their freedom to think or act in a You’re wrong.
certain way.

Sympathy Sympathy may be a compassionate I’m so sorry that your leg was
response however it is not effective amputated. It must be terrible.
as empathy in a therapeutic I’m so sorry you lost your
context. mother

Feeling sorry for the patient may

impair good judgment by the nurse
and anger the client.
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 NON-THERAPEUTIC
COMMUNICATION
Defensive Suggests criticism is unfounded Your doctor is quite capable.
Responses and that the patient has no right to I can’t believe that nurse
voice their opinion. would give you the wrong
medication.
No one here would…
Changing The The nurse takes the initiative for Patient: “I can’t stop thinking
Subject the interaction away from the about my diagnosis.” Nurse:
patient, which is usually due to “Let’s go for a walk now.”
the nurse’s discomfort.

Arguing Denies that the patient’s How can you say you didn’t
perception was real or accurate sleep a wink when I heard
you snoring all night?.

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