Therapeutic communication is the foundation of the modern approach to patient care. Patients need more than just physical treatment; their mental health and comfort also need to be considered.
If you are a current or prospective nurse, you probably heard the term during your degree – but how can you put it into practice?
Here are the 7 therapeutic communication methods you need to know.
What is Therapeutic Communication?
Therapeutic communication is a concept that is constantly evolving. Blow the dust off your old university textbooks and you will probably find a different definition to what is common today.
With that said, there are some broad characteristics that fall under the therapeutic communication umbrella.
First, therapeutic communication is about holistic patient care. In other words, using communication methods to care for a patient’s mental and emotional wellbeing, as well as their physical health.
It focuses on not treating the patient as a passive bystander, or as a problem to be fixed, but as an active participant in their own treatment.
To do this, nurses use a range of therapeutic communication methods to empower, inform and reassure their patients.
It may seem counterintuitive for the first therapeutic communication method to be silence. After all, most people would consider silence to be the opposite of communicating. The thing is, that isn’t true.
Think of a conversation as a space that fills up when someone is talking. If you constantly talk over a patient you will never hear what the patient has to say. By choosing not to speak, you give the patient a chance to convey their thoughts.
You are also giving the patient the ability to dictate whether the conversation continues. This is empowering for the patient, and how they respond to the responsibility may provide you with useful insights.
2. Event Placing
Being a patient can be disorientating. If they have been hospitalised, they are in an unfamiliar place surrounded by unfamiliar people, and without their daily routines. If they are in pain, they also probably can’t think clearly.
All of these factors can combine to cause a sense of timelessness. This means getting key information from a patient, or asking for consent to future treatment, can be difficult. It is also very distressing for the patient.
A therapeutic communication method to help this situation is to place events with clear dates or times so that the patient can piece together a timeline of events. For example, rather than asking if their pain is better than it was before, ask if their pain is better than it was three days ago.
‘Before’ is difficult to visualise, but three days ago gives a specific day that they can mentally backtrack too. This will help them understand their own progress while also giving you information to assist their treatment.
3. Paraphrasing and Clarifying
One of the more challenging aspects of nurse to patient communication is translating medical terminology into understandable information or instructions. To make sure patients comprehend what is being said, you can use paraphrasing and clarifying.
Paraphrasing patient responses, and paying attention to how they paraphrase yours, is a great way to check for understanding. When we paraphrase, we show that we understand well enough to take the important parts of the message and put them into simpler terms.
If the paraphrase doesn’t accurately summarise the message, you can then ask clarifying questions, or provide clarifying answers, to make sure you and the patient are on the same page.
It’s also important to look for signs of misunderstanding by reading their non-verbal cues. Not every patient will have the assertiveness to tell you if they don’t understand what you are saying.
4. Guiding the Conversation
Tools like empathy and humour are effective tools for building rapport with a patient, but there are also times when a serious discussion needs to take place.
Simply telling the patient to stop talking could offend them and worsen your relationship. Instead, the therapeutic communication method advises guiding the conversation back towards important points without the patient realising.
This is a sophisticated skill because it requires you to think on your feet. When patients go on tangents, or if they say something interesting that you need to pursue further, guide them back by incorporating it back into their story.
For example, if you are trying to assess how much pain a patient is in, but they keep telling you stories of past injuries to evade the question, respond by asking them how much that injury hurt on a scale of 1-10. When they answer, then ask them where their current injury would fit on the scale.
If you indulge their story briefly, the patient will feel validated. Then when you guide them back to your original question, they are more likely to answer. This acts as a compromise between you getting the information you need, and them still feeling comfortable.
Holding patients accountable is an unpleasant, but necessary, part of treatment. For example, if you believe a client is lying about taking medication, you can’t ignore that suspicion.
While you never want to be rude or condescending, that doesn’t mean you can’t confront a patient for behaving in a way that puts them at risk.
A good technique is to make observations rather than accusations. For example, rather than saying “I know you aren’t taking your medication”, try asking “I noticed your medication tray was still full, are you having trouble understanding which ones to take?”
By asking a question and offering assistance, the patient is much more likely to tell the truth or give insight into why they are behaving in a way that could cause them harm.
6. Giving Recognition
Giving recognition is the opposite of holding a patient accountable, but the therapeutic communication methods involved are the same.
Just as holding someone accountable can seem rude, giving recognition for simple tasks can seem patronising. For instance, if you have a patient who has managed to eat a full meal for the first time during their stay, that might be a milestone for you. But congratulating them simply for eating may remind them of their loss of independence.
Instead, tell them that you noticed their plate was empty. This way you have acknowledged their progress, but you are allowing them to attach their own emotional significance to it.
Touch is a therapeutic communication technique that is very effective but requires trust and awareness of the patient’s behaviour to be safe. Never touch a patient who is behaving aggressively or irrationally.
Physical gestures like a pat on the back for making progress, holding the hand of a scared patient, or even just a handshake when greeting them each day can all be more powerful than verbal cues. They provide a physical connection in an unfamiliar place where they may be separated from their loved ones.
Nurses Now is a nursing agency that believes in providing holistic patient care. That means all of our nurses value therapeutic communication methods – and we are always looking for more passionate nurses to join our ranks!
We offer positions in a range of healthcare sectors, from aged care to hospital acute care. We also offer flexible working hours. Pick the field and times that suit your needs.
If you are interested, or have friends or family who would be, please don’t hesitate to get in touch.