Therapeutic Communication

[LCinTraining]

We have this assignment where we have to have a ten minute long conversation with a patient. We then go back, write as much down, word for word as we can remember in columns. One column for the patient's words, one column for our words and one column for the type of therapeutic or non therapeutic technique we used. In any case, I have it all written down and I am at a loss for which type of technique it is.

Patient explains they are doing a home study to make sure the home is safe enough for her to go home.

I say "I hope that goes well for you."

I cannot for the life of me match it to any of the techniques provided on our list. So I thought I'd put it out there and see if you guys had any ideas.

My options are...

• silence
  
• giving recognition
  
• offering self
  
• open ended question
  
• offering general leads
  
• placing the event in time or sequence
  
• sharing perceptions
  
• theme identification
  
• restating
  
• reflection
  
• focusing
  
• exploring
  
• giving information
  
• verbalizing the implied
  
• suggesting collaboration
  
• summarizing
  
• encouraging formulation of plan
  
• reassuring
  
• approving/disapproving
  
• Why?
  
• Close ended questions
  
• introducing unrelated topic
  
• rejection advising
  
• probing/prying
  
• challenging
  
• defending
  
• belittling expressed feelings
  
• using stereotyped responses
  
• following standard forms too closely
  
• providing the answer with the question
  
• failure to listen
  

It just seems like none of these are a fit for this. I don't believe it's necessariliy therapeutic and about half of this list is non therapeutic, but I'm totally at a loss here and ready to invent a technique. LO

[LCinTraining]

Adding: I meant I wrote the entire conversation down, figured out all the other responses, and what forms of communication they were, and am stuck on that one particular statement.

[abercrombiechyki]

Im in the middle of doing the same thing, its def closed being youre not asking anything, im not sure what else I would name it though

[LCinTraining]

I know! But it's not a question lol.

[elkpark]

The obvious match from your list is "using stereotyped responses" (which is non-therapeutic).

[Esme12, ASN, BSN, RN]

I agree....."using stereotyped responses".

"They are doing a home check for safety? What things have they told you they are doing to make it safe for you?"

[LCinTraining]

Ok, explain what made that obvious. I feel like a dolt lol. The example given for stereotypes is "cat got your tongue?"So, wishing them well is considered non therapeutic, which I kind of understand on the surface, but I don't understand why it is considered non therapeutic.

[willowita, ADN, RN]

Well, your answer was not therapeutic because it didn't focus back on the patient's content and went into a generalized response. Anyone could have told them I wish you well and it's the kind of response that doesn't open or continue the conversation. It stops that particular topic. Maybe the patient had concerns, worries, expectations, questions, etc about the home study that could have been directed with paraphrasing, providing leads, or using an open ended question. We all say canned statements but as the nurse, or nursing student, we have to make sure our communication is directed and purposeful. A stereotypical response is not purposeful.

[LCinTraining]

So the fact that anyone could wish them well makes this stereotypical then?

[Stephalump]

I think what makes it stereotypical is that it isn't meaningful or thoughtful or particularly helpful. It doesn't encourage more expression from the patient, you know?

It's what you'd expect from a social interaction with someone you don't know very well (or maybe someone you do) but not so much a therapeutic relationship.

I just got done doing that project a few weeks ago. Not fun.

[Esme12, ASN, BSN, RN]

"So, how's that working out for you?" Doesn't give the patient a chance to express concerns. It leads to a single word answer. It doesn't help the nurse explore the patients needs and fears or if the patient has insight to their disease or needs within the limitations of their disease.

I wish you well sounds much nicer that .....So, how's that working out for you....

Patients have plenty of well wishers. They need their nurses to be advocators and teachers.

[CT Pixie, BSN, RN]

It's a cliche' type sentence which for us falls under non-therapeutic and as cliche'. But since you don't have a specific one that says that I'd say it goes with sterotyped response.