Therapeutic Communication
Therapeutic communication is a purposeful, goal-directed form of communication used by nurses to build rapport, gather patient information, and provide emotional support. It uses techniques such as active listening, open-ended questions, reflection, and clarification while avoiding non-therapeutic responses like giving advice or false reassurance.
Exam Tip
Therapeutic techniques: reflection, open-ended questions, active listening, silence, clarification. NON-therapeutic: false reassurance ("Don't worry"), giving advice, asking "why," changing the subject. The best response usually acknowledges the patient's FEELINGS. Look for responses that are patient-centered.
What Is Therapeutic Communication?
Therapeutic communication is a professional nursing skill that uses verbal and nonverbal strategies to establish a caring, therapeutic relationship with patients. Unlike social conversation, therapeutic communication is planned, patient-centered, and designed to meet the patient's physical and emotional needs.
Therapeutic Communication Techniques
| Technique | Description | Example |
|---|---|---|
| Active listening | Fully attending to the patient with undivided attention | Maintaining eye contact, nodding, leaning forward |
| Open-ended questions | Questions that require more than yes/no answers | "Tell me about the pain you're experiencing." |
| Reflection | Restating the patient's feelings back to them | Patient: "I'm scared." Nurse: "You're feeling scared about the surgery." |
| Clarification | Asking for more information to ensure understanding | "What do you mean when you say you feel 'off'?" |
| Restating/Paraphrasing | Repeating key points in the nurse's own words | "So you're saying the pain started after dinner?" |
| Silence | Allowing quiet time for the patient to think and process | Sitting quietly after a patient receives bad news |
| Summarizing | Reviewing main points of the conversation | "Today we discussed your medications and activity plan." |
| Offering self | Making yourself available to the patient | "I'll sit with you for a while." |
| Acknowledging | Recognizing the patient's feelings or efforts | "I can see this is difficult for you." |
| Focusing | Directing the conversation to an important topic | "Let's talk more about your breathing difficulty." |
NON-Therapeutic Communication (Avoid These)
| Non-Therapeutic Response | Why It's Harmful | Example to AVOID |
|---|---|---|
| False reassurance | Minimizes patient's feelings | "Don't worry, everything will be fine." |
| Giving advice | Takes away patient autonomy | "If I were you, I would..." |
| Asking 'why' | Can feel accusatory/judgmental | "Why didn't you take your medication?" |
| Changing the subject | Dismisses patient's concerns | "Let's not talk about that. How's your appetite?" |
| Agreeing/Disagreeing | Prevents patient from expressing feelings | "You're right" or "That's wrong" |
| Defending | Invalidates patient's feelings | "Your doctor is very good; I'm sure they know best." |
| Stereotyping | Shows bias and lack of individualized care | "All elderly patients forget their medications." |
| Approval/Disapproval | Implies judgment | "Good, you did the right thing." |
Exam Alert
Therapeutic communication is tested in the Psychosocial Integrity category on the NCLEX-PN (9-15%). When choosing the best nurse response, look for reflection, open-ended questions, and active listening. Eliminate options with false reassurance, advice-giving, "why" questions, or changing the subject. The correct answer focuses on the patient's feelings.
Study This Term In
Related Terms
Patient Advocacy
Patient advocacy is the act of supporting and protecting patients' rights, safety, and best interests within the healthcare system. Nurses serve as patient advocates by ensuring informed consent, protecting patient rights, facilitating communication, and speaking up when patient safety is at risk.
Nursing Process
The nursing process is a systematic, five-step problem-solving framework used by nurses to provide patient-centered care: Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE). It is the foundation of all nursing practice and the organizing framework for the NCLEX.
Care Plan (Nursing)
A nursing care plan is a written document that outlines a patient's identified health problems, measurable goals, and specific nursing interventions. It is developed by the RN based on nursing assessment data and guides the entire nursing team in providing consistent, individualized care.
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