THERAPEUTIC

COMMUNICATION
TECHNIQUES
 1. ACCEPTING
Indicating reception

Examples:

“Yes”

“I follow what you said”

Nodding
 RATIONALE
An accepting response indicates the nurse has heard
and followed the train of thought.

It does not indicate agreement and is not

judgmental.

Facial expression, tone of voice, and body language

must convey acceptance or the words will lose their
meaning.
 2. BROAD OPENING
Allowing the client to take the initiative in
introducing the topic

EXAMPLES:

“Is there something you’d like

to talk about?”

“Where would you like to begin?”

 RATIONALE

Broad openings make explicit that the client has the

lead in the interaction.

For a client who is hesitant about talking,

broad openings may stimulate him or her to
take the initiative.
 3. CONSENSUAL VALIDATION
Searching for mutual understanding, for accord
in the meaning of the words

EXAMPLES:

“Tell me whether my understanding

of it agrees with yours.”

“Are you using this word to convey that…”

 RATIONALE
For verbal communication to be meaningful,
it is essential that the words being used should have
the same meaning for all participants.

Sometimes words, phrases, or slang terms have different

meanings and can be easily understood.
 4. ENCOURAGING COMPARISON
Helping the client to understand by looking at
similarities and differences

EXAMPLES:

“Was it something like this…?”

“Have you had similar experiences?”

 RATIONALE

Comparing ideas, experiences, or relationships brings

out many recurring themes.

The client benefits from making these comparisons

because he or she might recall past coping strategies that
were effective or remember that
he or she has survived a similar situation.
 5. ENCOURAGING
DESCRIPTIONS OF
PERCEPTIONS
Asking client to verbalize what he or she perceives

Examples:

“Tell me when you feel anxious”

“What are you hearing?”

“What does the voice seem to be saying?”

 6. ENCOURAGING EXPRESSION
Asking the client to appraise the quality
of his or her experience.

EXAMPLES:

“What are your feelings in regard

to…?”

“Does this contribute to your distress?”

 RATIONALE

The nurse asks the client to consider people and

events in light of his or her own values

Doing so encourages the client to make his or her own

appraisal rather than accepting the opinion of others
 EXPLORING

Delving further into subject or idea

Examples:

“Tell me more about that.”

“Would you describe it more fully?”

“What kind of work?”

 RATIONALE

When clients deal with topics superficially, exploring can

help them examine the issue more fully.

Any problem or concern can be better understood if

explored in depth.

If the client expresses an unwillingness to explore a subject,

the nurse must respect his or her wishes.
 8. FOCUSING

Concentrating on a single point.

EXAMPLES:

“This point seems looking at more closely. You’ve

briefly mentioned 3 suicide attempts.”

“Of all the concerns you have mentioned, which is

most troublesome?”
 RATIONALE

The nurse encourages the client to concentrate his or

her energies on a single point, which may prevent a
multitude of factors or problems from overwhelming
the client.

It is also a useful technique when a client

jumps from one topic another.
 9. FORMULATING A PLAN
OF ACTION
Asking the client to
consider kinds of “What could you do
behavior likely to be EXAMPLES: to let your anger out
appropriate in future harmlessly?”
situations.

It will be helpful for the

“Next time this comes client to plan in advance
Up, what can you do RATIONALE what he or she might do
to handle it?” in future similar
situations.
 10. GENERAL LEADS

Giving encouragement to “Go on. I’m listening”

EXAMPLES:
continue

“Tell me more about it.

“And then” I hear what you are RATIONALE
saying.”

General leads indicate that the nurse is listening

They also encourage the client to continue if he or
and following what the client is saying without
she is hesitant or uncomfortable about the topic.
taking away the initiative
for the interaction
 11. GIVING INFORMATION
Making available the facts
that the client needs EXAMPLES: “My name is…”

“My purpose of being here

“Visiting hours are…” RATIONALE
is…”

Informing the client of facts increases his

Giving information also builds trust with the
or her knowledge about a topic or lets the client.
client know what to expect
 12. GIVING RECOGNITION

Acknowledge indicating
EXAMPLES: “Good morning Ms. A…”
awareness

“You’ve finished your list “I noticed that you’ve

RATIONALE
of things to do.” combed your hair.”

Greeting the client by name, indicating awareness of

change, or noting effects the client has made all show
that the nurse recognizes the client as a person.
 13. MAKING OBSERVATIONS

Verbalizing what the nurse

EXAMPLES: “You appear tensed.”
perceives

“You appear “I notice that you are biting

RATIONALE
uncomfortable.” your lip.”

Sometimes clients cannot verbalize or

Or the client may not be ready to talk
make themselves understood
 14. OFFERING SELF

Making oneself “I will sit with you for a

EXAMPLES:
available while.”

“I will stay here with you for

“I am interested in what
15 minutes and read a story.” RATIONALE
you think.”

It is important that this offer is unconditional.

The nurse can offer his or her presence,
The client does not have to respond verbally to get
interest, and desire to understand nurse’s attention.
 15. PLACING EVENT IN
TIME SEQUENCE
Clarifying the relationship “Were you frightened
or events in time EXAMPLES: before or after the movie?”

“Was this before or after?”

“When did this happen?” RATIONALE

Putting events in proper sequence helps both

the nurse and client to see them in perspective
 16. PRESENTING REALITY

Offering for “I see no one else in

consideration that EXAMPLES: the room.”
which is real.

When it is obvious that

“Your mother is not a client is misinterpreting
RATIONALE
here. I am a nurse.” reality, the nurse can
indicate what is real.
 17. REFLECTING

Directing client actions, Client:

Thoughts, and feelings EXAMPLES: “Do you think I should
back to the client tell the doctor?”

Client: “My brother

Nurse: Nurse:
spends all my money and
“Do you think you “This causes you to
then he has the nerve to
should?” feel angry?”
ask for more.?”
 RATIONALE

Reflection encourages the client to recognize and

accept his or her own feelings

The nurse indicates that the client’s point of view

has value, and that the client has the right to have
opinions, to make decisions, and to think
independently
 18. RESTATING
Client:
Repeating the main
EXAMPLES: “I can’t sleep. I stayed
idea expressed
awake all night.”

Nurse: Client: Nurse:

“You have difficulty “I am really mad. “You’re really mad and
sleeping.” I am really upset.” upset.”

The nurse repeats what the client has said in

RATIONALE approximately or nearly the same words the
client has used
 19. SEEKING INFORMATION
Seeking to make clear that “What do you mean by
which is not meaningful or that EXAMPLES: feeling sick inside?”
which is vague

The nurse should seek

Have I heard you
RATIONALE clarification throughout
correctly?”
interactions with clients

Doing so can help the nurse avoid

It helps client to articulate thoughts, feelings
making assumptions that understanding
and ideas more clearly
has occurred when it is not
 20. SILENCE

Absence of verbal communication, Nurse says nothing but

which provides time for the client continues to maintain
to put thoughts or feelings into EXAMPLES:
eye contact and convey
words, regain composure or
interest
continue talking

Silence often encourages Silence gives the client to

the client to verbalize organize thoughts, direct the
RATIONALE provided that he is topic of interaction, or focus on
interested and expectant issues that are most important
 21. SUGGESTING
COLLABORATION
Offering to share, to strive, to “Perhaps you and I can
work with the client for his or EXAMPLES: discuss and discover the
her benefit triggers of your anxiety.”

“Let’s go to your room and I The nurse seeks to offer a

will help you find what you RATIONALE relationship in which the client
are looking for.” can identify problems in living
with others, grow emotionally,
and improve
The nurse offers to do things with, rather than the ability to form satisfactory
for the client relationships.
 22. SUMMARIZING

Organizing and summing “So far, we have discussed

up that which has transpired EXAMPLES:
about…”

“During the past hour,

“You’ve said that…” RATIONALE
you and I have discussed…”

Summarization seeks to bring out the It allows both client and nurse to
important points of the discussion and It leaves out the irrelevant and organizes depart with the same ideas and
increase the awareness and the pertinent aspects of the interaction provides a sense of closure at the
understanding of both participants. completion of each discussion
 23. TRANSLATING INTO FEELINGS
Seeking to verbalize client’s feelings
that he or she expresses only EXAMPLES: Client: “I am dead.”
indirectly

Nurse: “Are you Client: “It’s a waste of time Nurse: “Do you feel that no
suggesting that you feel talking to anyone.” one understands?”
lifeless?”

To understand, the nurse must

Often the client says, when taken literally, concentrate on what the client might be
RATIONALE seems meaningless or far removed from feeling to express himself or herself this
reality way
 24. VERBALIZING THE IMPLIED

Voicing what the client Client:

has hinted at or EXAMPLES: “I can’t talk to you or anyone. It is
suggested a waste of time.”

Nurse: Putting words what the client has

implied or said indirectly tends to
“Do you feel that no one RATIONALE make the discussion less obscure
understands?”

The nurse should be as direct as possible

without being unfeelingly blunt.
 25. VOICING DOUBT

Expressing uncertainty about

the reality of the EXAMPLES: “Isn’t that unusual?”
client’s perceptions

“Really?” “That is hard to believe.” RATIONALE

Another means of responding to distortions of

reality is to express doubt.
NON-THERAPEUTIC
COMMUNICATION
RESPONSES
1. ADVISING
2. AGREEING
3. BELITTLING FEELINGS EXPRESSED
 4. CHALLENGING

Demanding proof from the client EXAMPLES:

“But how can you be the

President of the United “If you are dead, why is your
States?” heart beating?”

Challenging causes
the client to defend the
RATIONALE delusions or
misinterpretation more
strongly than before
5. DEFENDING
6. DISAGREEING
7. GIVING APPROVAL
8. INTERPRETING
9. INTRODUCING UNRELATED TOPICS
10. MAKING STEREOTYPED COMMENTS
11. REASSURING
12. REJECTING
13. REQUESTING AN EXPLANATION
14. TESTING
15. USING DENIAL
THANK YOU
FOR
LISTENING!