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Therapeutic
Communication
with Psychiatric
Clients
Joan Operario, MS, RN
Therapeutic Communication

“The nurses’ development of effective
communication in the health care setting
should begin in the nursing education
program” (Zavertnik, Huff, & Munro, 2010, p.
65).

basic skills needed for psychiatric nursing
practice:
a) effective communication
b) therapeutic use of self
Therapeutic Communication

Effective communication
consists of application of
therapeutic communication
techniques such as:
Active listening
Seeking clarification
Exploring meanings
Restating
Asking open-ended questions
Refrain from asking “WHY?”
Frequently/Regularly check for
understanding

Therapeutic use of self:
Awareness of self
Clarification of values
Exploration of feelings
Serving as role model
Altruism
Ethics and responsibility
Therapeutic Communication

Responsive Dimensions are
significant in establishing rapport,
trust, and open communication
with the client.

Action Dimensions facilitates
interpersonal relationships and
identifies the obstacles to client’s
progress.

Nurses must possess these
qualities to establish such. These
are:
genuineness
respect
empathy
concreteness

Nurses must implement these
actions in order to assist in client’s
change in behavior. These are:
confrontation
immediacy
nurse self-disclosure
emotional catharsis
role playing
boundaries
Therapeutic Communication
Barriers that may be encountered:

Resistance

Transference

Countertransference

Boundary violations
References
Shattell, M. and Hogan, B. (2005). Facilitating communication:
How to truly understand what patients mean. Journal of
Psychosocial Nursing & Mental Health Services,
43(10), 29-32.
Stuart, G. W. (2009). Therapeutic nurse-patient relationship.
Principles and practice of psychiatric nursing (9th ed.).
St. Louis, MO: Mosby Elsevier.
References
Wolf, Z. A. (2001). Communicating for the first time with
delusional patients. Journal of the American
Psychiatric Nurses Association, 7,155-162. doi:
10.1067/mpn.2001.118610
Zavertnik, J.E., Huff, T.A., & Munro C.L. (2010). Innovative
approach to teaching communication skills to nursing
students. Journal of Nursing Education, 49(2), 65-71.