Chapter Therapeutic Communication Skills © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Importance of Communication • Therapeutic communication – – – – – Introduces element of empathy Specific and well-defined professional skills Foundation of all patient care Nontechnical language Technically accurate © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part The Communication Cycle • Two or more individuals exchanging information • Sending and receiving messages • Four basic elements – – – – Sender Message and channel or mode of communication Receiver Feedback © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part The Communication Cycle The communication cycle and channels of communication >> © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part The Communication Cycle • The sender – Encoding or creating message to be sent • The message – Content being communicated – Must be understood clearly by receiver – Four modes of communication • • • • Speaking Listening Gestures or body language Writing © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part The Communication Cycle • The receiver – Recipient of sender’s message – Must decode (interpret) meaning of message – Sensory skill in verbal communication is listening • Feedback – After receiver has decoded message sent by sender – Receiver’s way of ensuring message that is understood is same as message sent © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part The Communication Cycle • Listening skills – Active listening: received message sent back to sender, worded a little differently, for verification from sender – Listening with a “third ear” © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part The Communication Cycle • Listening skills – Listening goals • Improve listening skills so patients are heard accurately • Listen either for what is not being said or for information transmitted only by hints • Determine how accurately message has been received © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Types of Communication • Verbal communication – Takes place when message is spoken – Sender and receiver must apply same meaning to spoken words © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Types of Communication • Verbal communication – The Five Cs of communication • • • • • Complete Clear Concise Cohesive Courteous © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Congruency in Communication • Perception – Conscious awareness of one’s own feelings and the feelings of others – Sense another’s attitudes, moods, feelings – Follow perceived assessments with verbal validation – Easily misinterpreted © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Factors Affecting Therapeutic Communication • Barriers – – – – – Age Economic Education and life experience Bias and prejudice Verbal roadblocks © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Factors Affecting Therapeutic Communication • Defense mechanisms – – – – – – – – – Regression Denial Repression Projection Sublimation Displacement Compensation Rationalization Undoing © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Factors Affecting Therapeutic Communication • Barriers caused by cultural and religious diversity – – – – Communication context Caregiving expectations Time focus Attitude toward Western medicine © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Factors Affecting Therapeutic Communication • Human needs as barriers to therapeutic communication Maslow’s hierarchy of needs >> © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Factors Affecting Therapeutic Communication • Patient with special needs – – – – English as a second language Audio challenged Visually challenged Mental cognition Environmental and time factors â 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Establishing Multicultural Communication • The patient must trust the professional • Steps to building trust: – – – – – Risk/trust Conveying empathy Showing respect Being genuine Active listening © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Establishing Multicultural Communication • Cultural brokering – Bridging, linking, mediating between groups or persons through process of reducing conflict or producing change – Cultural broker serves as go-between – One who advocates on behalf of another individual or group within health care community © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Establishing Multicultural Communication • Cultural brokering – Increase capacity of health care and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems – Cultural broker may assume role of medical interpreter © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Establishing Multicultural Communication • Cultural brokering – Interpreters not provide word-for-word equivalence, but rather focus on accurate expression of equivalent meaning – Remember to speak directly to patient, not to interpreter © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Establishing Multicultural Communication • Cultural brokering – Family member may serve as interpreter – Family member may not understand medical terminology – Difficult for family member to share a lifethreatening diagnosis or a poor prognosis © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Therapeutic Communication in Action • Interview techniques – Closed questions: answered with simple yes or no – Open-ended questions: patient required to verbalize more information – Indirect statements: elicit response from patient without patient feeling questioned © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Therapeutic Communication in Action • Interview techniques – Silence: gives patient time to put their feelings and thoughts into words – Feedback: words and nonverbal cues important; offer encouragement to patient to continue – Give recognition – Offer comfort © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Therapeutic Communication in Action • Point of care techniques – Location where patient and provider or patient and office personnel physically interact – Barrier to communication is emotional tension © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part Community Resources • Need to refer patient to community resource • List of community resources readily available © 2014 Cengage Learning All Rights Reserved May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part ... creating message to be sent • The message – Content being communicated – Must be understood clearly by receiver – Four modes of communication • • • • Speaking Listening Gestures or body language Writing... skill in verbal communication is listening • Feedback – After receiver has decoded message sent by sender – Receiver’s way of ensuring message that is understood is same as message sent © 2014... heard accurately • Listen either for what is not being said or for information transmitted only by hints • Determine how accurately message has been received © 2014 Cengage Learning All Rights