Communication: Concept, Features and

Process (With Diagram)

Communication might be defined as follows:
Communication might be defined as the
transfer of – facts, information, ideas,
suggestions, orders, requests, grievances etc.
from one person to another so as to impart a
complete understanding of the subject matter
of communication to the recipient thereof; the
desired response from the recipient to such
communication
UNDERSTANDING THE COMMUNICATION IN
MENTAL HEALTH

BY
ADEGOKE ADEDAYO A
DEPT OF NURSING SCIENCE OAU ILE IFE
 Some popular definitions of
communication are given below
• :
• (1) “Communication is a way that one organisation member
shares meaning and understanding with another.” -Koontz
and O’Donnell
• (2) “Communication is the process of passing information
and understanding from one person to another.” -Keith
Davis
• (3) “Communication is the sum of the things one person
does when he wants to create understanding in the mind of
another. It is a bridge of meaning. It involves a systematic
and continuous process of telling, listening and
understanding.” Louis A. Allen
 Process of Communication

The process of communication consists of the following steps or

stages:
• (ii) Sender:
The actual process of communication is initiated at the hands of
the sender; who takes steps to send the message to the recipient

• (i) Message:
This is the background step to the process of communication;
which, by forming the subject matter of communication
necessitates the start of a communication process. The message
might be a factor an idea, or a request or a suggestion, or an
order or a grievance.
 Communication process cont’d
.(iii) Encoding:
Encoding means giving a form and meaning to the
message through expressing it into – words, symbol,
gestures, graph, drawings etc.
• (iv) Medium:
It refers to the method or channel, through which the
message is to be conveyed to the recipient. For
example, an oral communication might be made
through a person or over the telephone etc.; while a
written communication might be routed through a
letter or a notice displayed on the notice board etc.
 Communication process cont’d
• (v) Recipient (or the Receiver):
Technically, a communication is complete, only when it comes to
the knowledge of the intended person i.e. the recipient or the
receiver.
• (vi) Decoding:
Decoding means the interpretation of the message by the
recipient – with a view to getting the meaning of the message, as
per the intentions of the sender. It is at this stage in the
communication process, that communication is philosophically
defined as, ‘the transmission of understanding.’
(vii) Feedback: To complete the communication process, sending
feedback to communication, by the recipient to the sender is
imperative. ‘Feedback’ implies the reaction or response of the
recipient to the message, comprised in the communication.
 All told, communication is a circular process, as
illustrated, by means of the following circular diagram
 Psychoanalytic Theory Of Communication

• Sigmund Freud, a trained neurologist popularly

known as the father of psychoanalysis
• Psychoanalytic theories are a complex set of
theories and principles to understand and to
study the human behavior, personality, logic and
thoughts of a person.
• Sigmund Freud is the pioneer in developing these
theories followed by many psychologists like Erik
Erikson. The theories are vast and are
unpredictable at times as the behavior of a
human mind.
 Basic Concepts of psychoanalysis
• Mind is divided into three sections:
• Conscious mind is the feelings and desires that
you feel at present
• Preconscious is the memory or any event that you
find it easy to recollect and also the humanitarian
part
• Unconscious which is the vast area which will be
difficult to recollect but these will be memories
caused by the experiences of our conscious
behavior
 Structure of personality in psychoanalytic
theory
• During 1923 Sigmund Freud divided the mind
into three stages is called “Personality
Structure”.
• ID (“eedh”)
• Ego
• Super Ego
 structure of personality contd
Id is the first stage, the human wants to fulfill
their desire (demand) whether it is right or
wrong.
Individual seeks for pleasure and to avoid the
pain. There is no moral values or standards in
this stage. It’s unconscious mind
Example: The child never stops crying until the
mother fulfills the desire of the kid. (Kid fighting
for Ice cream)
 Structure of personality cont’d
• 2. Ego is the second stage which is the balance
between both id and superego on one hand &
reality on another hand.
• In this stage individual demands as well as obey
for the reality principle (real life). It’s stands in
between both conscious and preconscious
• Example: In the University campus, Students
are protesting or demanding for their
scholarship in a democratic way
 Structure of personality cont’d
• 3. Super Ego is the third stage which is entirely
opposite to the Id.
• In the stage the individual concerned with moral
values, emotions, expectation, standards and
ideals. It is mostly unconscious and some part is
preconscious
• Example: A good politician has several ways to
involve in scam. Even though, he will not do that
because of his ethical and moral values won’t allow
 Therapeutic Communication in Psychiatric Nursing

INTRODUCTION
• The nurse-client relationship is the foundation on
which psychiatric nursing is established.
• The therapeutic interpersonal relationship is the
process by which nurses provide care for clients in
need of psychosocial intervention.
• Mental health providers need to know how to gain
trust and gather information from the patient, the
patient's family, friends and relevant social relations,
and to involve them in an effective treatment plan.
 Therapeutic comm. In nursing
• Therapeutic use of self is the instrument for
delivery of care to clients in need of
psychosocial intervention.
• Interpersonal communication techniques are
the “tools” of psychosocial intervention.
 Requirements for Therapeutic Relationship

• Rapport
• Trust
• Respect
• Genuineness
• Empathy
 Therapeutic Communication in
Psychiatric Nursing
Phases of a Therapeutic Nurse-Client
Relationship
• Pre-interaction phase
• Orientation/Introductory Period
• Working
(Termination Hildeard Peplau)
 INTERPERSONAL COMMUNICATION
• Interpersonal communication is a transaction between
the sender and the receiver. Both persons participate
simultaneously.
• In the transactional model, both participants perceive
each other, listen to each other, and simultaneously
engage in the process of creating meaning in a
relationship, focusing on the patients issues and
assisting them learn new coping skills.
• Both sender and receiver bring certain preexisting
conditions to the exchange that influence the intended
message and the way in which message is interpreted
 CONTEXT OF THERAPEUTIC
COMMUNICATION
• Values, attitudes, and beliefs.
Example: attitudes of prejudice are expressed
through negative stereotyping.
• Culture or religion
Cultural mores, norms, ideas, and customs
provide the basis for ways of thinking
 CONTEXT OF THERAPEUTIC
COMMUNICATION
• Social status
• High-status persons often convey their high-power
position with gestures of hands on hips, power dressing,
greater height, and more distance when communicating
with individuals considered to be of lower social status.
• Gender
Masculine and feminine gestures influence messages
conveyed in communication with others.
CONTEXT OF THERAPEUTIC COMMUNICATION

• Age or developmental level

Example: The influence of developmental level
on communication is especially evident during
adolescence, with words such as “cool,”
“awesome,” and others.
• The environment
Territoriality, density, and distance are aspects of
environment that communicate messages.
THERAPEUTIC COMMUNICATION TECHNIQUES

• Using silence - allows client to take control of the discussion,

if he or she so desires
• Accepting - conveys positive regard
• Giving recognition - acknowledging, indicating awareness
• Offering self - making oneself available
• Giving broad openings - allows client to select the topic
• Offering general leads - encourages client to continue
• Placing the event in time or sequence - clarifies the
relationship of events in time
• Making observations - verbalizing what is observed or
perceived
 THERAPEUTIC COMMUNICATION TECHNIQUES

• Encouraging description of perceptions - asking client to verbalize

what is being perceived
• Encouraging comparison - asking client to compare similarities and
differences in ideas, experiences, or interpersonal relationships
• Restating - lets client know whether an expressed statement has or
has not been understood
• Reflecting - directs questions or feelings back to client so that they
may be recognized and accepted
• Focusing - taking notice of a single idea or even a single word
• Exploring - delving further into a subject, idea, experience, or
relationship
• Seeking clarification and validation - striving to explain what is
vague and searching for mutual understanding
 THERAPEUTIC COMMUNICATION
TECHNIQUES
• Presenting reality - clarifying misconceptions that client
may be expressing
• Voicing doubt - expressing uncertainty as to the reality of
client’s perception
• Verbalizing the implied - putting into words what client has
only implied
• Attempting to translate words into feelings - putting into
words the feelings the client has expressed only indirectly
• Formulating plan of action - striving to prevent anger or
anxiety escalating to unmanageable level when stressor
recurs
 THERAPEUTIC COMMUNICATION AND PROBLEM-SOLVING

• Goals are often achieved through use of the problem-

solving model:
• Identify the client’s problem.
• Promote discussion of desired changes.
• Discuss aspects that cannot realistically be changed
and ways to cope with them more adaptively.
• Discuss alternative strategies for creating changes
the client desires to make.
•
THERAPEUTIC COMMUNICATION AND PROBLEM-SOLVING

• Weigh benefits and consequences of each

alternative.
• Help client select an alternative.
• Encourage client to implement the change.
• Provide positive feedback for client’s
attempts to create change.
• Help client evaluate outcomes of the change
and make modifications as required.
 LISTENING TO THE PATIENT
• To listen actively is to be attentive to what client is saying, both verbally
and nonverbally.
• Several nonverbal behaviors have been designed to facilitate attentive
listening.
• S – Sit squarely facing the client.
• O – Observe an open posture.
• L – Lean forward toward the client.
• E – Establish eye contact.
• R – Relax.
• Feedback is useful when it
• is descriptive rather than evaluative and focused on the behavior rather
than on the client
• is specific rather than general
• is directed toward behavior that the client has the capacity to
modify imparts information rather than offers advice.
 Non therapeutic Communication
Techniques
• Giving reassurance - may discourage client from further expression of feelings if
client believes the feelings will only be downplayed or ridiculed
• Rejecting - refusing to consider client’s ideas or behavior
• Approving or disapproving - implies that the nurse has the right to pass
judgment on the “goodness” or “badness” of client’s behavior
• Agreeing or disagreeing - implies that the nurse has the right to pass judgment
on whether client’s ideas or opinions are “right” or “wrong”
• Giving advice - implies that the nurse knows what is best for client and that client
is incapable of any self-direction
• Probing - pushing for answers to issues the client does not wish to discuss causes
client to feel used and valued only for what is shared with the nurse
• Defending - to defend what client has criticized implies that client has no right to
express ideas, opinions, or feelings
Non therapeutic Communication Techniques
• Requesting an explanation - asking “why” implies that client must defend his
or her behavior or feelings
• Indicating the existence of an external source of power - encourages client to
project blame for his or her thoughts or behaviors on others
• Belittling feelings expressed - causes client to feel insignificant or unimportant
• Making stereotyped comments, clichés, and trite expressions - these are
meaningless in a nurse-client relationship
• Using denial - blocks discussion with client and avoids helping client identify
and explore areas of difficulty
• Interpreting - results in the therapist’s telling client the meaning of his or her
experience
• Introducing an unrelated topic - causes the nurse to take over the direction of
the discussion
 What is Echolalia?

• Echolalia is a normal part of speech development in humans.

• Echolalia is human behavior involving the repetition of words or
sounds, either immediately after hearing the auditory stimulus
or after time has passed.
• The first stage of language development is free operant pairings,
wherein the child will imitate sounds, but not whole words. For
example, when the parent says "Say Mama!" the child might
say, "mmm".
• All free operant pairings are a functional type of echolalia. The
next phase is direct echolalia, in which the child is parroting
complete words or short phrases. As the child gets older and
their verbal behavior begins to blossom
 What is Echolalia?
• around the age of three years old, they'll start to begin expressing
their thoughts and ideas rather than simply repeating the speech
and sounds found in their environment.
• Slowly, echolalia is phased out in favor of functional verbal behavior
that is correctly communicating the needs of the child.
• Echolalia past the point of about four years old is considered
developmentally concerning. It is a common behavior in children
with autism, developmental delays, and other types of
neurodiversity and can be a lifelong symptom for the people that
experience it.
• Echolalia can sometimes be referred to as parroting; however, this
term can sometimes be perceived as derogatory and therefore the
term echolalia is preferred in clinical and academic settings
 Types of echolalia
• There are three types of echolalia.
• Immediate echolalia directly follows the auditory stimulus. An example
of this would be a small child making "chugga-chugga-choo-choo!"
noises after seeing a real train. It's important to remember that not all
echolalia involves words, but can often involve interesting sounds found
in the environment.

• Mitigated echolalia involves modification of the original auditory

stimulus, often to experiment with new words or add communicative
meaning. For example, a father may say "bye-bye!" to their two-year-
old, who responds "bye-bye Dada!" Adding the word "Dada" after the
original stimulus changes the meaning of the echolalia and indicates the
entrance of the second stage of verbal development described above.
 Types of echolalia
• Lastly, there is delayed echolalia. Delayed echolalia
occurs when someone repeats an auditory stimulus after
a period of time.
• This type of echolalia is the least likely to have a
functional meaning because it is not associated with the
immediate verbal or social stimulus. When the same
delayed echolalia occurs consistently with no outward
influence, it can be called scripting.
• An example of this would be a young man constantly
repeating the same lines of a movie to himself.
• It can also be interactive and non interactive
 Echolalia vs Echopraxia

• Echopraxia is the involuntary copying of another person's

physical movements.
• It's important to note that echolalia is almost always
voluntary, and echopraxia is completely involuntary.
Echopraxia is common in people with schizophrenia,
autism, and Tourette's syndrome, as well as people who
have experienced a severe stroke or traumatic brain injury.
• Selective examples of echopraxia are common to the
majority of humanity, including body language mirroring
when engaged in conversation and yawning after
someone else has yawned
 Echopraxia
• An example of clinically significant echopraxia would be a
child copying the hand movements of their mother in the
kitchen while they're attempting to eat dinner at the
dinner table, interrupting their ability to consume the
meal.
• People who experience echopraxia may also involuntarily
repeat violent actions they see, like kicking or punching.
• An example of clinically significant echolalia may be an
adult yelling what they heard on the radio that morning,
out of context, while sitting on the bus on the way to
work.
 Selective mutism
• It is defined by in the diagnostic and stastical manual of mental
disorders as an anxiety disorder charaterized by a consistent
failure to speak in social situations in which there is an
expectation to speak (eg school )
• in which individual speaks in order situations It may also be
defined as an inability or unwillingless to speak resulting in
absence or marked paucity of verbal output Mutism can occur
in functional or organic state ,It can occur in adults but more
common in children Failure to speak has signifant consequences
on achievement and academic or occupational or interferes
with normal social interaction of the child,selective mutism is
common and affect 1in 140 children usually around age 2-4,
 Selective mutism
• The child may be talkative at home but
communictes differently with others and
usually use one syllable words and may be
attached to their parents The condition is
usually treated with cognitive behaviour
therapy by exposing gradually to anxiety
provoking situations
 Other speech disorders in mental health

• Apraxia ;here an individual has trouble making accurate

movement when speaking this usualy occur when the
brain has difficulty coordinating the movements
• Articulation disorder; based on inability to form certain
words and sounds which may be distorted such as
making ‘th’ sound in place of ‘s’
• Stutering it can come in different forms including blocks
xtetrized by long pauses prolongation and repetitions
• Receptive disorders this is xterized by trouble
understanding and processing what others say
 Therapeutic Communication in Depression

• People suffering from depression have negative

thoughts that lead to feeling depressed. While
these thoughts need to be changed, depressed
people are sometimes uninterested in the world
around them and are easily discouraged.
• Therapeutic communication encourages a depressed
person to examine and change his negative or
distorted thought patterns, while maintaining
sensitivity and therapeutic rapport. Therapists use a
number of techniques to achieve these goals.
Therapeutic Communication in Depression

Provide Education
A depressed person is sometimes unaware she is suffering
from a mental illness so the therapist communicates
information on the disorder, its prevalence, symptoms and
prognosis.
• Therapists share with the patient that, according to the
Diagnostic and Statistical Manual of Mental Disorders,
depression is a commonly occurring mental disorder
with over 5 percent of the population of the United
States meeting the criteria for depression as of the
manual's 2000 publication date.
Therapeutic Communication in Depression

• Communicate to the patient that the depression

she is experiencing is different from just having
the blues in that depression is the predominant
feeling experienced throughout the day.
• It's important to explain to the patient that
with treatment her prognosis is good. Only one
tenth of the people suffering from depression
remain depressed after two years.
 Communication in depression
• Validate Feelings
• Communicate to the patient that you understand how he is
feeling. Paraphrase what he is saying by repeating one or two
key words that summarize the concept and let him know you
understand. Say something like, “It seems the last year has
been very hard for you. Anyone would feel depressed going
through what you have been through."
• Communicate to the patient that you understand how he is
feeling.
• Paraphrase what he is saying by repeating one or two key
words that summarize the concept and let him know you
understand.
 Communiction in depression
• Focus on the Present
• Depressed people sometimes want to ruminate. Offer
hope and confidence that her problems will get better
with continued therapy. This encouragement is a
lifeline to a depressed person. Try saying, “While the
past year was tough, I’m confident you and I will work
together to help you feel better and move on with
your life.”
• Depressed people sometimes want to ruminate.
• This encouragement is a lifeline to a depressed person
 Communication in depression
• Ask for Clarification
• Confused thoughts are a symptom of depression
so the therapist works toward helping the
patient clearly state what he is thinking. Asking
questions, paraphrasing and summarizing are
helpful communication techniques to help the
patient achieve clarity. Try using the phrase, “If
I’m understanding you right…” to assist the
patient to organize his thoughts.
 Communication in violence
• Violence and Aggression • Violence and aggression
refer to a range of behaviours or actions that can
result in harm, hurt or injury to another person,
regardless of whether the violence or aggression is
physically or verbally expressed, physical harm is
sustained or the intention is clear
• Usually the majority of Psychiatric patients are not
Hostile, Dangerous or aggressive, BUT occasionally
Psychiatric Illness presented in Aggressive Behavior
 Violence causes
• Antisocial & Borderline Personality Disorder.
• . Hypomania or mania >>> may be angry & hostile if they are
obstructed
• Schizophrenia >> due to Delusional beliefs or in response to auditory
Hallucination. Catatonic type : outbursts of over activity &/or
aggressive behavior. Alcohol & Drugs:- Alcohol >> reduce self-control>>
aggression C.N.S. stimulants ( amphetamine ) >> over activity & over
stimulation >>> Aggression. Heroin addicts during Withdrawal phase.

• . Dementia:- cerebral damage , decreased control aggression .

delirium: clouding of consciousness , diminished comprehension,
anxiety, perplexity, delusion of persecution , Aggression. 6. Epilepsy:- in
the post-epileptic confessional state
 violence
• Positive predictors of violence:
Male gender
• Prior history of violence
• Psychiatric illness Drug or ethanol abuse
PREVENTION OF VIOLENCEPOLICY
• - Never attempt to evaluate an armed patient
- Carefully search for any kind of offensive weapon (
by the security ) –
• Anticipate possible violence from hostile,
threatening behavior, & from restless, agitated
abusive pts –
• , Nurses, relatives should treat such patient with
understanding & gentleness as possible. - Adequate
security. - Raise of alarm. –
• Availability of more staff.
 Violence contd
• Keep the door open for an exit
- No obstruction to exit for you or pt. –
• Do NOT bargain with a violent person.
Reassure the patient and encourage self
control and cooperation Remain calm, non-
critical
 Violence management
• Management Options: Verbal de-escalation
Physical restrains
Chemical restrains.

• Verbal de-escalation
• Calm,
• slow talking Be firm and assertive
Avoid argumentative or condescending
language.
 Violence management

• physical restrains - Assign one team member to each of the pts

head and extremities.
• - Be humane but firm, don’t bargain.
• - Use minimum force.
• - Start together to hold the patient and accomplish restraint
quickly
• Chemical restrains. antypsychotic medication

• Typical
. Chlorpromazine mg im . Droperidol 10-20mg im or iv. . Clopixol
Aquaphase mg im Atypical - Risperidone 4mg - Zyprexia 10mg im.
 History taking in mental health
• .  Name
•  Age
•  Sex
•  Marital Status
•  Religion  Occupation  Socio-economic status 
Address  Informant  Information (Relevant or not)
adequate or not.  – In patient’s own words & in
information’s own words. Eg: - Sleeplessness X 3
weeks - Loss of appetite & hearing voices X 2 weeks -
talking to self X 2 weeks
 History taking contd
• Onset - Acute (within a few hours) -Subacute
(within a few days) - Gradual (within a few weeks)
 Duration – days, weeks or months  Intensity /
same / increasing or decreasing  Precipitating
factors – yes / no (if yes explain)  History of
current episode (explain in detail regarding the
presenting complaints)  Associated disturbances –
include present medical problems (eg: Disturbance
in sleep, appetite, IPR & social functioning,
occupation etc).
 History taking contd
• Number of episode with onset & course  Complete or
incomplete remission  Duration of each episode 
Treatment details & its side effects if any  Treatment
outcomes  Detail if any precipitating factors if present
• Past Medical History: b) Past Surgical History c) Obstetrical
History (Female) 7.  Family genogram – 3 generations
include only grandparents.  But if there is a family history
include the particular generation 8.  Pre-natal history –
Maternal infection - Exposure to radiation etc. – Check ups –
Any complications  Natal history: - Types of delivery -Any
complications -Breath & cried at birth  Mile Stones: -
Normal or delayed
• Behaviour during childhood: - Excessive temper tantrums -
Feeding habit - Neurotic symptoms - Pica - Habit disorders -
Excretory disorders etc.  Illness during childhood - Look
specifically for CNS infections - Epilepsy -Neurotic disorder 
Malnutrition
• 10.  Schooling - Age of going to school - Performance in the
school -Relationship with teachers (Specifically look for
learning disability & attention deficit) - Look for conduct
disorders Eg. Truancy, stealing  Occupational history - Age
of joining job - Relationship with superiors, subordinates &
colleagues - Any changes in the job – if any give detail -
Reasons for changing jobs
 History contd
• Sexual history - Age of attaining puberty (female-menstrual
cycles are regular) -Source & extent of knowledge about
sex, any exposures - Marital status: with genogram

• (Personality of a patient consists of those habitual attitudes

& patterns of behaviour which characterize an individual.
Personality sometimes changes after the onset of an illness.
Get a description of the personality before the onset of the
illness. Aim to build up a picture of the individual, not a
type. Enquire with respect to the following areas)
• Attitude to others in social, family & sexual relationship:
Ability to trust other, make & sustain relationship, anxious
or secure, leader or follower, participation, responsibility,
capacity to make decision, dominant or submissive,
friendly or emotionally cold, etc. difficulty in role taking –
gender, sexual, familial. 2. Attitudes to self: Egocentric,
selfish, indulgent, dramatizing, critical, d epreciatory, over
concerned, self conscious, satisfaction or dissatisfaction
with work. Attitudes towards health & bodily functions.
Attitudes to past achievements & failure, & to the future.
 Hisrory contd
• . Moral & religious attitudes & standards: Evidence of
rigidity or compliance, permissiveness or over
consciousness, conformity, or rebellion. Enquire
specifically about religious beliefs. 4. Mood: Enquire
about stability of mood, mood swing, whether anxious,
irritable; worrying or tense. Whether lively or gloomy.
Ability to express & control feelings or anger, anxiety, or
depression. 5. Leisure activities & hobbies: Interest in
reading, play, music, movies etc. enquire about creative
ability. Whether leisure time is spent along or with
friends. Is the circle of friends large or small
 History contd
• Fantasy life: Enquire about content of day
dreams & dreams. Amount of time spent in day
dreaming. 7. Reaction pattern to stress: Ability
to tolerate frustrations, losses,
disappointments, & circumstances arousing
anger, anxiety or depression. Evidence for the
excessive use of particular defense mechanism
such as denial, rationalization, projection, etc.
8. Habits: Eating, sleeping & excretory functions
 Types of admission
• Voluntary admission
• Other types of admission
These types of admissions are classified as follows:
• Involuntary care, treatment and rehabilitation: when someone
who needs to be hospitalised is incapable of making informed
decisions due to his/her mental health status and refuses health
intervention
• Assisted care, treatment and rehabilitation: this means the
provision of health interventions to people incapable of making
informed decisions due to their mental health status and who do
not refuse the health interventions. An example would be a
mentally ill person who is found wandering the streets and is
unaware of what is happening to him/her.
 Allowance in mental health
• This is a benefit domeone with mental
disability or other disability get for upkeep
Confidentiality and exceptions in psychiatry

• WHAT IS CLIENT CONFIDENTIALITY?

• Confidentiality includes not just the contents
of therapy, but often the fact that a client is in
therapy.
• For example, it is common that therapists will
not acknowledge their clients if they run into
them outside of therapy in an effort to protect
client confidentiality. Other ways
confidentiality is protected include:
 Confidentiality contd
• Not leaving revealing information on voicemail
or text.
• Not acknowledging to outside parties that a
client has an appointment.
• Not discussing the contents of therapy with a
third party without the explicit permission of
the client
 EXCEPTIONS TO CONFIDENTIALITY RULES

• Licensed mental health professionals can

break confidentiality in some circumstances.
One of the most common scenarios is when
• a client is a threat to himself/herself or others,
in which case a therapist must
notify the person in danger or notify someone
who can keep the client safe. In these
circumstances, therapists often seek
hospitalization for their clients.
• I thank you