2.1. INTRODUCTION
Learning Objectives
Review basic concepts of client-centered communication
Outline effective therapeutic communication techniques
Describe barriers to effective therapeutic communication
Explore guidelines for effective communication during teletherapy
Nurses engage in compassionate, supportive, professional relationships with their clients as part of the “art of nursing.” [1]This chapter will review the nurse-client relationship, therapeutic communication, and motivational interviewing. It will also introduce teletherapy and telehealth.
References
- 1.
American Nurses Association. (2021).Nursing: Scope and standards of practice(4th ed.). American Nurses Association.
2.2. BASIC CONCEPTS OF COMMUNICATION
Communication Standard of Professional Performance
The Standard of Professional Performance forCommunicationestablished by the American Nurses Association (ANA) is defined as, “The registered nurse communicates effectively in all areas of professional practice.” [1]See the following box for the competencies associated with theCommunicationstandard.
ANA’s Communication Competencies
The registered nurse:
Assesses one’s own communication skills and effectiveness.
Demonstrates cultural humility, professionalism, and respect when communicating.
Assesses communication ability, health literacy, resources, and preferences of health care consumers to inform the interprofessional team and others.
Uses language translation resources to ensure effective communication.
Incorporates appropriate alternative strategies to communicate effectively with health care consumers who have visual, speech, language, or communication difficulties.
Uses communication styles and methods that demonstrate caring, respect, active listening, authenticity, and trust.
Conveys accurate information to health care consumers, families, community stakeholders, and members of the interprofessional team.
Advocates for the health care consumer and their preferences and choices when care processes and decisions do not appear to be in the best interest of the health care consumer.
Maintains communication with interprofessional team members and others to facilitate safe transitions and continuity in care delivery.
Confirms with the recipient if the communication was heard and if the recipient understands the message.
Contributes the nursing perspective in interactions and discussions with the interprofessional team and other stakeholders.
Promotes safety in the care or practice environment by disclosing and reporting concerns related to potential or actual hazards or deviations from the standard of care.
Demonstrates continuous improvement of communication skills.
Review basic communication concepts for nurses in the “Communication” chapter in Open RNNursing Fundamentals.
Nurse-Client Relationship
Establishment of the therapeutic nurse-client relationship is vital in nursing care. Nurses engage in compassionate, supportive, professional relationships with their clients as part of the “art of nursing.” [2]This is especially true in psychiatric care, where the therapeutic relationship is considered to be the foundation of client care and healing. [3]Thenurse-client relationshipestablishes trust and rapport with a specific purpose; it facilitates therapeutic communication and engages the client in decision-making regarding their plan of care.
Therapeutic nurse-client relationships vary in depth, length, and focus. Brief therapeutic encounters might last only a few minutes and focus on the client’s immediate needs, current feelings, or behaviors. For example, in the emergency department setting, a nurse may therapeutically communicate with a client in crisis who recently experienced a situational trauma. During longer periods of time, such as inpatient care, nurses work with clients in setting short-term goals and outcomes that are documented in the nursing care plan and evaluated regularly. In long-term care settings, such as residential facilities, the therapeutic nurse-client relationship may last several months and include frequent interactions focusing on behavior modification.
Read more about crisis and crisis intervention in the “Stress, Coping, and Crisis Intervention” chapter.
Phases of Development of a Therapeutic Relationship
The nurse-client relationship goes through three phases. A well-known nurse theorist named Hildegard Peplau described these three phases as orientation, working, and termination. [4]
Orientation Phase
During the brief orientation phase, clients may realize they need assistance as they adjust to their current status. Simultaneously, nurses introduce themselves and begin to obtain essential information about clients as individuals with unique needs, values, beliefs, and priorities. During this brief phase, trust is established, and rapport begins to develop between the client and the nurse. Nurses ensure privacy when talking with the client and providing care and respect the client’s values, beliefs, and personal boundaries.
A common framework used for introductions during patient care is AIDET, a mnemonic for Acknowledge, Introduce, Duration, Explanation, and Thank You.
Acknowledge:Greet the patient by the name documented in their medical record. Make eye contact, smile, and acknowledge any family or friends in the room. Ask the patient their preferred way of being addressed (for example, “Mr. Doe,” “Jonathon,” or “Johnny”) and their preferred pronouns (e.g., he/him, she/her, or they/them).
Introduce:Introduce yourself by your name and role. For example, “I’m John Doe, and I am a nursing student working with your nurse to take care of you today.”
Duration:Estimate a timeline for how long it will take to complete the task you are doing. For example, “I am here to perform an admission assessment. This should take about 15 minutes.”
Explanation:Explain step by step what to expect next and answer questions. For example, “I will be putting this blood pressure cuff on your arm and inflating it. It will feel as if it is squeezing your arm for a few moments.”
Thank You:At the end of the encounter, thank the patient and ask if anything is needed before you leave. In an acute or long-term care setting, ensure the call light is within reach and the patient knows how to use it. If family members are present, thank them for being there to support the patient as appropriate. For example, “Thank you for taking time to talk with me today. Is there anything I can get for you before I leave the room? Here is the call light (Place within reach). Press the red button if you would like to call the nurse.”
Working Phase
The majority of a nurse’s time with a client is in the working phase. During this phase, nurses use active listening and begin by asking the reason the client is seeking care to determine what is important to them. They use assessment findings to develop a nursing plan of care and plan patient education. If a care plan has already been established on admission, nurses use this time to implement interventions targeted to meet short-term outcomes and long-term goals. During the working phase, clients begin to accept nurses as health educators, counselors, and care providers. Nurses use therapeutic communication techniques to facilitate clients’ awareness of their thoughts and feelings and mutually develop goals and an individualized plan of care. Nurses provide reflective and nonjudgmental feedback to clients to help them clarify their thoughts, goals, and coping strategies. [5]Therapeutic communication techniques used during this phase, including motivational interviewing, are discussed later in this chapter.
Termination Phase
The final phase of a nurse-client relationship is the termination phase. This phase typically occurs at the end of a shift or on discharge from care. If the previous working phase has been successful, the client’s needs have been successfully met by collaboration among the client, nurses, and interprofessional health care team members. The nurse should be aware the client may try to return to the working phase to avoid termination of the relationship. During the termination phase, the nurse can encourage the client to reflect on progress they have made and review post-discharge goals. The nurse also makes community referrals for follow-up and continuation of support in meeting goals.
References
American Nurses Association. (2021).Nursing: Scope and standards of practice(4th ed.). American Nurses Association.
American Nurses Association. (2021).Nursing: Scope and standards of practice(4th ed.). American Nurses Association.
Ross C. A., Goldner E. M. Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: A review of the literature. Journal of Psychiatric and Mental Health Nursing. 2009;16(6):558–567. [PubMed: 19594679] [CrossRef]
Hagerty T. A., Samuels W., Norcini-Pala A., Gigliotti E. Peplau’s Theory of Interpersonal Relations: An alternate factor structure for patient experience data? Nursing Science Quarterly. 2018;30(2):160–167. [PMC free article: PMC5831243] [PubMed: 28899257] [CrossRef]
Hagerty T. A., Samuels W., Norcini-Pala A., Gigliotti E. Peplau’s Theory of Interpersonal Relations: An alternate factor structure for patient experience data? Nursing Science Quarterly. 2018;30(2):160–167. [PMC free article: PMC5831243] [PubMed: 28899257] [CrossRef]
2.3. THERAPEUTIC COMMUNICATION
Therapeutic communication has roots going back to Florence Nightingale, who insisted on the importance of building trusting relationships with patients. She taught that therapeutic healing resulted from nurses’ presence with patients. [1]Since then, several professional nursing associations have highlighted therapeutic communication as one of the most vital elements in nursing.Therapeutic communicationis a type of professional communication defined as the purposeful, interpersonal, information-transmitting process that leads to client understanding and participation. [2]Read an example of a nursing student using therapeutic communication in the following box.
Example of Nurse Using Therapeutic Listening
Ms. Z. is a nursing student (as simulated in Figure 2.1) [3]who enjoys interacting with patients. When she goes to patients’ rooms, she greets them and introduces herself and her role in a calm tone. She kindly asks patients about their problems and notices their reactions. She provides information and answers their questions. Patients perceive that she wants to help them. She treats patients professionally by respecting boundaries and listening to them in a nonjudgmental manner. She addresses communication barriers and respects patients’ cultural beliefs. She notices patients’ health literacy and ensures they understand her messages and patient education. As a result, patients trust her and feel as if she cares about them, so they feel comfortable sharing their health care needs with her. [4]
Figure 2.1
Nursing Student Using Therapeutic Communication
Therapeutic communication is different from social interaction. Social interaction does not have a goal or purpose and includes casual sharing of information, whereas therapeutic communication has a goal or purpose for the conversation. An example of a nursing goal before using therapeutic communication is, “The client will share feelings or concerns about their treatment plan by the end of the conversation.”
Therapeutic communication includes active listening, professional touch, and a variety of therapeutic communication techniques.
Active Listening
Listening is an important part of communication. There are three main types of listening, including competitive, passive, and active listening. Competitive listening occurs when we are mostly focused on sharing our own point of view instead of listening to someone else. Passive listening occurs when we are not interested in listening to the other person, and we assume we understand what the person is communicating correctly without verifying their message. Duringactive listening, we communicate both verbally and nonverbally that we are interested in what the other person is saying while also actively verifying our understanding with them. For example, an active listening technique is to restate what the person said and then verify our understanding is correct. This feedback process is the major difference between passive listening and active listening. [5]
Nonverbal communication is an important component of active listening.SOLERis a mnemonic for establishing good nonverbal communication with clients. SOLER stands for the following [6]:
S:Sitting and squarely facing the client
O:Usingopen posture (i.e., avoid crossing arms)
L:Leaning towards the client to indicate interest in listening
E:Maintaining goodeye contact
R:Maintaining arelaxed posture
Touch
Professional touch is a powerful way to communicate caring and empathy if done respectfully while also being aware of the client’s preferences, cultural beliefs, and personal boundaries. Nurses use professional touch when assessing, expressing concern, or comforting patients. For example, simply holding a patient’s hand during a painful procedure can effectively provide comfort.
For individuals with a history of trauma, touch can be negatively perceived, so it is important to ask permission before touching. Inform the person before engaging in medical procedures requiring touch such as, “I need to hold down your arm so I can draw blood.”
Nurses should avoid using touch with individuals who are becoming agitated or experiencing a manic or psychotic episode because it can cause escalation. It is also helpful to maintain a larger interpersonal distance when interacting with an individual who is experiencing paranoia or psychosis.
Therapeutic Communication Techniques
There are a variety of therapeutic techniques that nurses use to engage clients in verbalizing emotions, establishing goals, and discussing coping strategies. See Table 2.3a for definitions of various therapeutic communication techniques discussed in theAmerican Nurse, the official journal of the American Nurses Association.
Table 2.3a
Therapeutic Communication Techniques [7]
Nontherapeutic Responses
Nurses must be aware of potential barriers to communication and avoid nontherapeutic responses. Nonverbal communication such as looking at one’s watch, crossing arms across one’s chest, or not actively listening may be perceived as barriers to communication. Nontherapeutic verbal responses often block the client’s communication of feelings or ideas. See Table 2.3b for a description of nontherapeutic responses to avoid.
Table 2.3b
Nontherapeutic Responses [8],[9]
See the following box for a summary of tips for using therapeutic communication and avoiding common barriers to therapeutic communication.
Tips for Effective Therapeutic Communication
Establish a goal for the conversation.
Be self-aware of one’s nonverbal messages.
Observe the client’s nonverbal behaviors and actions as ‘cues’ for assessments and planning interventions.
Avoid self-disclosure of personal information and use professional boundaries. (Review boundary setting in the “Boundaries” section of Chapter 1.)
Be patient-centered and actively listen to what the client is expressing (e.g., provide empathy, not sympathy; show respect; gain the client’s trust; and accept the person as who they are as an individual).
Be sensitive to the values, cultural beliefs, attitudes, practices, and problem-solving strategies of the client.
Effectively use therapeutic communication techniques.
Recognize themes in a conversation (e.g., Is there a theme emerging of poor self-esteem, guilt, shame, loneliness, helplessness, hopelessness, or suicidal thoughts?).
Common Barriers to Therapeutic Communication
Using a tone of voice that is distant, condescending, or disapproving.
Using medical jargon or too many technical terms.
Asking yes/no questions instead of open-ended questions.
Continually asking “why,” causing the client to become defensive or feel challenged by your questions.
Using too many probing questions, causing the client to feel you are interrogating them, resulting in defensiveness or refusal to talk with the nurse.
Lacking awareness of one’s biases, fears, feelings, or insecurities.
Causing sensory overload in the client with a high emotional level of the content.
Giving advice.
Blurring the nurse-client relationship boundaries (e.g., assuming control of the conversation, disclosing personal information, practicing outside one’s scope of practice).
Recognizing and Addressing Escalation
When communicating therapeutically with a client, it is important to recognize if the client is escalating with increased agitation and becoming a danger to themselves, staff, or other patients. When escalation occurs, providing safety becomes the nurse’s top priority, and the focus is no longer on therapeutic communication. Read more information in the “Crisis and Crisis Intervention” section of the “Stress, Coping, and Crisis Intervention” chapter.
Cultural Considerations
Recall the discussion from Chapter 1 on how cultural values and beliefs can impact a client’s mental health in many ways. Every culture has a different perspective on mental health. For many cultures, there is stigma surrounding mental health. Mental health challenges may be considered a weakness and something to hide, which can make it harder for those struggling to talk openly and ask for help. Culture can also influence how people describe and feel about their symptoms. It can affect whether someone chooses to recognize and talk openly about physical symptoms, emotional symptoms, or both. Cultural factors can determine how much support someone gets from their family and community when it comes to mental health. [10]
Nurses can help clients understand the role culture plays in their mental health by encouraging therapeutic communication about their symptoms and treatment. For example, a nurse should ask, “What do you think is wrong? How would you treat your symptoms?”
Read more about providing culturally responsive care in the “Diverse Clients” chapter of Open RNNursing Fundamentals.
References
- 1.
Karimi H., Masoudi Alavi N. Florence Nightingale: The mother of nursing. Nursing and Midwifery Studies. 2015;4(2):e29475. [PMC free article: PMC4557413] [PubMed: 26339672] [CrossRef]
- 2.
Abdolrahimi M., Ghiyasvandian S., Zakerimoghadam M., Ebadi A. Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician. 2017;9(8):4968–4977. [PMC free article: PMC5614280] [PubMed: 28979730] [CrossRef]
- 3.
- 4.
Abdolrahimi M., Ghiyasvandian S., Zakerimoghadam M., Ebadi A. Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician. 2017;9(8):4968–4977. [PMC free article: PMC5614280] [PubMed: 28979730] [CrossRef]
- 5.
This work is a derivative ofHuman RelationsbyLibreTextsand is licensed underCC BY-NC-SA 4.0.
- 6.
Stickley T. From SOLER to SURETY for effective non-verbal communication. Nurse Education in Practice. 2011;11(6):395–398. [PubMed: 21489877] [CrossRef]
- 7.
American Nurse. (n.d.).Therapeutic communication techniques.https://www
.myamericannurse .com/therapeutic-communication-techniques/ - 8.
Abdolrahimi M., Ghiyasvandian S., Zakerimoghadam M., Ebadi A. Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician. 2017;9(8):4968–4977. [PMC free article: PMC5614280] [PubMed: 28979730] [CrossRef]
- 9.
StatPearlsby Sharma & Gupta is licensed underCC BY 4.0.
- 10.
Mental Health First Aid USA. (2019, July 11).Four ways culture impacts mental health.National Council for Mental Wellbeing.https://www
.mentalhealthfirstaid .org/2019 /07/four-ways-culture-impacts-mental-health/
2.4. MOTIVATIONAL INTERVIEWING
Patient education and health promotion are core nursing interventions.Motivational interviewing (MI)is a communication skill used to elicit and emphasize a client’s personal motivation for modifying behavior to promote health. MI has been effectively used for several health issues such as smoking cessation, diabetes, substance use disorders, and adherence to a treatment plan. [1]
The spirit of motivational interviewing is a collaborative partnership between nurses and clients, focused on patient-centered care, autonomy, and personal responsibility. It is a technique that explores a client’s motivation, confidence, and roadblocks to change. During motivational interviewing, nurses pose questions, actively listen to client responses, and focus on where the client is now with a current health behavior and where they want to be in the future. [2]
Motivational interviewing uses these principles [3]:
Express empathy.Use reflective listening to convey acceptance and a nonjudgmental attitude. Rephrase client comments to convey active listening and let clients know they are being heard.
Highlight discrepancies.Help clients become aware of the gap between their current behaviors and their values and goals. Present objective information that highlights the consequences of continuing their current behaviors to motivate them to change their behavior.
Adjust to resistance.Adjust to a client’s resistance and do not argue. The client may demonstrate resistance by avoiding eye contact, becoming defensive, interrupting you, or seeming distracted by looking at their watch or cell phone. Arguing can place the client on the defensive and in a position of arguing against the change. Focus on validating the client’s feelings.
Understand motivations.Uncover a client’s personal reasons for making behavioral changes and build on them.
Support self-efficacy.Encourage the client’s optimistic belief in the prospect of change and encourage them to commit to positive behavioral changes. Ask clients to elaborate on past successes to build self-confidence and support self-efficacy.
Resist the reflex to provide advice.Avoid imposing your own perspective and advice.
When implementing motivational interviewing, it is important to assess the client’s readiness for change. Motivational interviewing is especially useful for clients in the contemplation stage who are feeling ambivalent about making change. Recall these five stages of behavioral change [4]:
Precontemplation:Not considering change.
Contemplation:Ambivalent about making change.
Preparation:Taking steps toward implementing change.
Action:Actively involved in the change process.
Maintenance:Sustaining the target behavior.
Identify clients who are ambivalent about making a behavioral change or following a treatment plan by listening for the phrase, “Yes, but.” The “but” holds the key for opening the conversation about ambivalence. For example, a client may state, “I want to take my medication, but I hate gaining weight.” The content in the sentence after the “but” reveals the client’s personal roadblock to making a change and should be taken into consideration when planning outcomes and interventions. [5]
See the following box for an example of a nurse using motivational interviewing with a client.
Example of Motivational Interviewing [6]
Mr. L. had been in treatment for bipolar I disorder with medication management and supportive therapy for many years. He had a history of alcohol dependence but was in full recovery. Mr. L. was admitted to the intensive care unit with a toxic lithium level. He had been seen in the emergency room the preceding evening and was noted to have a very high blood alcohol level. The next day the nurse asked the client about his alcohol use using motivational interviewing.
Client:I am so sick of everyone always blaming everything on my drinking!
Nurse (Using reflective listening):You seem pretty angry about the perception that you were hospitalized because you had been drinking.
Client:You better believe it! I am a man! I can have a few drinks if I want to!
Nurse: (Expressing empathy and acceptance):You want to be respected even when you are drinking.
Client:I have had some trouble in the past with drinking, but that is not now. I can quit if I want to! Compared to what I used to drink, this is nothing.
Nurse (Rolling with resistance):So you see yourself as having had drinking problems in the past, but the drinking you’ve done recently is not harmful for you.
Client:Well, I guess I did end up in the hospital.
Nurse (Using open-ended questioning):Tell me more about what happened.
Client:I was pretty angry after an argument with my girlfriend, and I decided to buy a bottle of whiskey.
Nurse (Exploring):And then?
Client:Well, I meant to have a couple of shots, but I ended up drinking the whole fifth. I really don’t remember what happened next. They said I nearly died.
Nurse (Summarizing):So after many years of not drinking, you decided to have a couple of drinks after the argument with your girlfriend, but unintentionally drank enough to have a blackout and nearly die.
Client:I guess that does sound like a problem…but I don’t want anyone else telling me whether or not I can drink!
Nurse (Emphasizing autonomy):Tell me how the choice to drink or not continues to support or oppose your health goals.
View the following supplementary YouTube videos about motivational interviewing:
Complete Western Region Public Health Training Center’sMotivational Interviewingcourse and receive a certificate of completion.
References
- 1.
Rubak S., Sandbaek A., Lauritzen T., Christensen B. Motivational interviewing: A systematic review and meta-analysis. The British Journal of General Practice: The Journal of the Royal College of General Practitioners. 2005;55(513):305–312. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1463134/ [PMC free article: PMC1463134] [PubMed: 15826439]
- 2.
Droppa M., Lee H. Motivational interviewing: A journey to improve health. Nursing. 2014;44(3):40–46. [PubMed: 24463613] [CrossRef]
- 3.
Droppa M., Lee H. Motivational interviewing: A journey to improve health. Nursing. 2014;44(3):40–46. [PubMed: 24463613] [CrossRef]
- 4.
Droppa M., Lee H. Motivational interviewing: A journey to improve health. Nursing. 2014;44(3):40–46. [PubMed: 24463613] [CrossRef]
- 5.
Droppa M., Lee H. Motivational interviewing: A journey to improve health. Nursing. 2014;44(3):40–46. [PubMed: 24463613] [CrossRef]
- 6.
Griffith, L. J. (2008). The psychiatrist's guide to motivational interviewing.Psychiatry (Edgmont, PA: Township),5(4), 42–47.https://www.ncbi.nlm.nih.gov/pubmed/19727309. [PMC free article: PMC2719555] [PubMed: 19727309]
- 7.
Matulich, B. (2013, May 30).Introduction to motivational interviewing[Video]. YouTube. All rights reserved.https://youtu
.be/s3MCJZ7OGRk. - 8.
TheRETAchannel. (2013, July 18).Motivational interviewing - Good example - Alan Lyme[Video]. YouTube. All rights reserved.https://youtu
.be/67I6g1I7Zao.
2.5. TELETHERAPY AND TELEHEALTH
Telehealthis the use of digital technologies to deliver medical care, health education, and public health services by remotely connecting multiple users in separate locations. Nurses must be aware of potential barriers affecting client use of telehealth (such as lack of Internet access or lack of support for individuals learning new technologies), as well as state and federal policies regarding telehealth and their nursing license across state lines.
Read more about telehealth licensing requirements and interstate compacts at theTelehealth.hss.gov webpage.
Teletherapyis mental health counseling over the phone or online with videoconferencing. COVID-19 has led to reduced access to medical and mental health care, so delivering behavioral health care via telehealth is one way to address this issue. When using teletherapy, nurses should treat clients as if they are sitting across from them and focus on eye contact and empathetic expressions to build a connection, just during a face-to-face encounter. [1]
Group therapy can be accomplished via telehealth. Connecting clients through telehealth creates a group dynamic that can build community, reduce feelings of isolation, and offer new perspectives. Group therapy via telehealth can create a sense of belonging and build a trusted support system.
Here are a few guidelines for group therapy telehealth sessions [2]:
Prescreen group members:Group members may have various needs, experiences, or personalities. It is helpful to screen each potential client to ensure every member can benefit from group therapy and that their needs match the goals of the group.
Require completion of online consent forms:Group telehealth sessions involve multiple people and are conducted outside of a controlled setting like an office. Client consent forms should be required and available online. The consent forms should outline any associated risks, benefits, and limits to confidentiality.
Develop group guidelines:Make clear ground rules covering what is acceptable and what is not acceptable. Some common ground rules include requiring all participants to have their camera on, attend from a room where they can be alone during the session, and use the digital “raise hand” feature (or raise their hand) when they want to speak. Prohibiting recording of the session is a common ground rule to protect confidentiality. Address logistical topics like how many missed sessions are allowed and how to contact the group leader(s).
Select your settings and technology:Choose the telehealth video platform that best suits your needs for encryption and privacy, user controls, and more. Go through all of the settings ahead of time to select the options that provide the highest level of privacy. Think about what will help you and the group communicate effectively such as screen sharing options or a virtual whiteboard.
Be engaging:When you are on screen instead of in person, it is even more important to be conscious of the group dynamic and take steps to keep group members interested, energized, and engaged. Start with introductions and greetings using first names only for privacy. Make eye contact with group members by looking into the camera and use body language and hand gestures to help express your ideas. Build in moments for clients to interact and contribute to the conversation, such as breakout rooms or paired discussions.
References
- 1.
TELEHEALTH.HHS.GOV. (2021, July 2).Individual teletherapy.Health Resources & Services Administration.https://telehealth
.hhs .gov/providers/telehealth-for-behavioral-health /individual-teletherapy/ - 2.
TELEHEALTH.HHS.GOV. (2021, July 2).Individual teletherapy.Health Resources & Services Administration.https://telehealth
.hhs .gov/providers/telehealth-for-behavioral-health /individual-teletherapy/
2.6. LEARNING ACTIVITIES
II. GLOSSARY
- Active listening
Communicating both verbally and nonverbally that we are interested in what the other person is saying while also actively verifying our understanding with them.
- Motivational interviewing (MI)
A communication skill used to elicit and emphasize a client’s personal motivation for modifying behavior to promote health.
- Nurse-client relationship
A relationship that establishes trust and rapport with a specific purpose of facilitating therapeutic communication and engaging the client in decision-making regarding their plan of care.
- SOLER
A mnemonic for effective nonverbal communication that stands for the following [1]:
S: Sit and squarely face the client
O: Open posture
L: Lean towards the client to indicate interest in listening
E: Eye contact
R: Relax
- Telehealth
The use of digital technologies to deliver medical care, health education, and public health services by remotely connecting multiple users in separate locations.
- Teletherapy
Mental health counseling over the phone or online with videoconferencing tools.
- Therapeutic communication
A type of professional communication defined as the purposeful, interpersonal, information-transmitting process that leads to client understanding and participation. [2]
References
- 1.
Stickley T. From SOLER to SURETY for effective non-verbal communication. Nurse Education in Practice. 2011;11(6):395–398. [PubMed: 21489877] [CrossRef]
- 2.
Abdolrahimi M., Ghiyasvandian S., Zakerimoghadam M., Ebadi A. Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician. 2017;9(8):4968–4977. [PMC free article: PMC5614280] [PubMed: 28979730] [CrossRef]
