...Related Literature 1 Therapeutic Communication Case Study by Quality Writers Description This paper discusses therapeutic communication from the point of view of the writer's clinical experiences as a nurse. It discusses the concept of therapeutic communication and how important verbal and nonverbal communication is with patients. The paper presents a case study that the writer was involved in and discusses how therapeutic communication was successful or unsuccessful in this scenario. 1 From the Paper: "Even when the nurse has experience with therapeutic communication, there can still be the problem of a breakdown in that communication. The nurse can have empathy, respect for the person, and use active listening skills, but the problem could still come about. The reason it happens is that the nurse also needs to do critical thinking. That kind of thinking means that that she is always assessing the patient and the situation (McNabb, 2006). Another point is that sometimes it can be very difficult to see things from the perspective of the patient. Bournes and Mitchell (2002, p. 59) state, "health is the way people go on and live what is important to them, moment to moment and day to day". Health for me is very different than it is for a person such as Mrs. A. The only way I can understand her experience is by empathy and through active listening." 2 Sample of Sources Used: 1. Bournes, D. & Mitchell, G. (2002). Waiting: The experience of persons in...
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...the client than other healthcare professionals (McCabe and Timmins 2006). Therefore, nurses have to pay more attention to improving their communication skills for better client care. In order to establish a positive relationship with the client, it is necessary to communicate effectively and subsequently improve the quality of nursing care (McCabe and Timmins 2006). Effective communication is key to a therapeutic relationship with the client. It is defined as a ''purposeful form of communication used in the helping relationship'' (Ruesch 1961 cited in Arnold and Boggs 2007, p18). It is developed by the nurse for the purpose of assessing, planning, implementing and evaluating client care (Arnold and Boggs 2007). The establishment of a nurse-client relationship was a key element of Peplau's (1952) work. Peplau (1952) suggested that the interpersonal relationship between the nurse and the client developed through four stages (orientation, identification, exploration and resolution) in order to accomplish client growth (McCabe and Timmins 2006). The purpose of therapeutic communication is not just about treating an illness but is also about giving the client a sense...
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..."There are a broad range of counselling micro skills that can be utilized effectively in therapy sessions. Within the context of their personal history, effective micro skill applications can encourage clients to tell their stories in colourful and extensive detail. Such effective implementation of micro skills facilitates the development of rapport and a positive therapeutic alliance thereby permitting clients to enrich their perspectives regarding problem and opportunity situations in their lives (Egan, 2007). Three important counseling techniques will be explored, all of which have been clinically demonstrated to be efficacious in a broad range of counseling settings (Egan). The skills of active listening, empathy and sharing empathic highlights will be discussed and analysed within the framework of a counselling case study. Accordingly, the purpose of this paper is to examine the use, efficacy and deficiencies of how these skills were employed within a counselling session with a mother, let's call her Mary. Mary presented to counselling with a five year history of frustrated attempts to get her daughter to sleep consistently in her own bed. On one hand, she had gone to extraordinary efforts to influence and sustain effective sleep patterns in her daughter. On the other, a feeling of being out of control permeated drained resourcefulness. Mary felt she was too compliant with her daughter's unwilling behaviour and sought help from a counsellor. The surface structure of...
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...This assignment will focus on a short communication between myself and a mother (Caroline) whom I had met three times before, at the antenatal, birth, and six-to-eight week contacts. I had cancelled a three-to-four month visit with her that day on the advice of my mentor. Caroline was an experienced mum and the visit had been mainly to aid my development (Appendix One). She had sounded fine on the phone and had told me she was coming into clinic. Borton’s (1970) reflective model will be used to guide this essay, and I will analyse how the experience has improved my skills in building therapeutic relationships, while recognising areas that require work in order to fulfil my role. All names have been changed to protect confidentiality, as is the responsibility of any registered nurse (NMC 2008). Mental and emotional wellbeing in all family members is intrinsic to the wellbeing of children. The “Healthy Child Programme” (DH 2009) identifies the assessment and promotion of this area as a core part of the health visitor’s role. A common mental health problem that impacts on children is post-natal depression, affecting 10-15% of women (Royal College of Psychiatrists n.d.). Infants whose mothers have post-natal depression often have less positive life outcomes, as discussed in Every Child Matters (HM Treasury 2003). It can impact negatively on emotional, social and mental development, often demonstrated through behavioural problems (Wrate et al., 1985), and neurological problems (Dale...
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...Communication is an art as well as a skill and affects all we do. Whatever the forum or platform used, communication is how we express information, thoughts and concerns. Healthcare communication is an entity all its own and requires careful study and understanding. In no other type of interaction can miscommunication or misunderstanding have grave consequences if information is not sent and processed correctly. According to “Impact of Communication in Healthcare” (2011), “Research evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors (para. 1). Learning and applying the art of healthcare communication encompasses thorough understanding, establishes relevancy with both the professional and layperson, affects health outcomes, while having profound influence on therapeutic contact. Before asserting healthcare communication it is necessary to explore the definition of communication itself. Northouse & Northouse (1998) offer human communication is the exchange of ideas involving the use of language and symbols. In the animal kingdom, however; communication still takes places without the use of spoken language and symbols as the human species knows it but rather utilizes sounds and behaviors. Healthcare communication is much narrower in scale and expresses ideas or concerns...
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...client continue talking and elaborate on the topic at hand. Encouraging behaviors include verbal and non-verbal cues from the counselor. Verbal encouragement can be as simple as a verbal utterance such as, “uh-huh” or a restatement with the tone of a question such as, “So you were really angry” (Ivey, A. Ivey, Zalaquett, & Quirk, 2012). The counselor meeting with Aaron, Robin and Michelle does this very effectively, throughout the session (Laureate Education, 2010). He says, “uh-huh” and “yes” multiple times along with open gestures that seem to be an invitation to open up and continue. They are very nuanced but seem very effective in keeping the conversation moving forward. Paraphrasing with Check In Paraphrasing in an active listening skill in which the counselor reflects back, with empathy and openness, what the client has said, in the counselor’s own words...
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...Nursing Dr. Bonnie Smith NR 451 Capstone Course Draft Design for Change Introduction A patient is admitted to a psychiatric unit on an involuntary basis or on voluntary basis. When a patient is deemed dangerous to himself/herself or others, they are admitted to the psychiatric unit against their wishes, or involuntarily. When a person goes to the hospital on their own to get help, they are admitted on a voluntary basis. In both cases, the patient is evaluated, stabilized in the Psychiatric ER, and then sent to the inpatient unit. Once they’re in the in-patient unit, they refuse treatment and become non-compliant to medication. The longer they refuse, the sicker they get, and begin to act out. The last option is to force medicate the patient, and that is not a pretty picture. Before it escalates to the point of forcing medication, are there any interventions a nurse can employ to lead a patient to compliance? Strategies/interventions nurses used for non-compliant patients were engagement, formulating a therapeutic relationship, and finding out why. (Vuckovich, 2009). Self-determination was a concept discussed by Corrigan et al. (2012). Interventions that promoted self-determination led to patient compliance. This paper will explore those interventions, and how they can achieve compliance to treatment in psychiatric patients. Change Model Overview Rosswurm and Larrabee (1999) proposed a model for change based on theoretical and research literature, related...
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...cognitive behavioral therapy to the fictional client’s case. I will conceptualize the fictional client’s case by applying the corresponding techniques and terms to meeting the specific needs of the clients. I will conclude the paper with specific therapeutic goals for the fictional client and assess the limitations to the incorporation of multiculturalism within the therapeutic approach. Fictional Client My fictional client is named Amber Fleming. Amber is a 20-year-old junior in college. Amber has an eating disorder in which she...
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...physiotherapist, a diversional therapist, a pastoral counsellor, an art therapist, a hypnotherapist, a counsellor, a psychologist, a behaviour therapist and many others could all be loosely termed or grouped as therapists. A constable and a sergeant are both police officers but one more highly recognised and a similar comparison could be made between a counsellor and a psychotherapist. An interesting point to note also is that studies have revealed/concluded that paraprofessionals (those with somewhat minimal training such as those who have only had a few hours of training in communication skills such as active listening, using reflective skills, empathy and the like, and others such as college students and those with no formal qualifications in "therapy") can obtain very positive results in working with those presenting for treatment of general life problems. In other words, many people can be aided in a "therapeutic" relationship or atmosphere with non-professionals (non-therapists) as much as certain professional people who are therapists. It's not always the case such as in adults who present with more disturbing issues, but the point is that helpers may not absolutely need to be an "expert therapist" in order for others (generally speaking and in general situations) to reap benefits of personal interaction in dealing with general life issues. Certain types of theories and those used in many forms of counselling state and believe that humans have the capacity for self-healing with...
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...of Person-Centred Therapy and try to establish whether a therapist can treat all clients effectively using just the one approach or whether it is more beneficial to the client for the therapist to use a more multi-disciplinary approach. To be able to discuss this subject, it is important to describe first what we mean when discussing PCT. Person-Centred Therapy, also known as client-centred, non-directive, or Rogerian therapy, is an approach to counselling and psychotherapy that places much of the responsibility for the treatment process on the client, with the therapist taking a non-directive role. PCT emphasises person to person relationship between the therapist and client and focuses on the client’s point of view; through active listening the therapist tries to understand the client’s present issues and emotions. In PCT the client determines the direction, course, speed and length of the treatment and the therapist helps increase the client’s insight and self-understanding. A person whose name is given to this approach is Carl Ransom Rogers. He was an influential American psychologist, who, along with Abraham Maslow, was the founder of the humanist approach to clinical psychology. “Human potential movement, dating back to the beginning of the 1900s, reflected an altered perspective of human nature. Previous psychological theories viewed human beings as inherently selfish and corrupt. For example, Freud's theory focused on sexual and aggressive tendencies as the primary...
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...Applying an Integrated Approach to a Case Example: Cognitive Behavioral Therapy and Person Centered Therapy Applying an Intergraded Approach to a Case Example: Cognitive Behavioral Therapy and Person Centered Therapy Theory plays an important role in the process and outcome of therapy. For this reason, it is a topic that is examined in depth in human service education programs and research. Theory is used to explain client problems and to dictate what is done in the counseling process (Hackney, 1992). Theory can be used to define “the nature of the relationship between the counselor and client, to conceptualize the nature of the presenting problem(s), and to define the resulting counseling goals or desired outcomes” (p.2). In the past, much focus has been paid on delineating and accentuating the differences between the many theories of therapy (Sprenkle, 2003, p. 93). Today, there is a move towards convergence of theories within the helping practices (Hackney, 1992, p. 3; Sprenkle, 2003). Researchers and practitioners are searching for an integrated approach which emphasizes the key components within the helping process and relationship that have been linked to effective therapy (Hackney, 1992, p.2). Cognitive-behavioral therapy (CBT) and Person-Centered Therapy (PCT) have been shown to bring about positive changes in therapy. CBT and PCT, like all single-theory approaches, have limitations. Literature suggests that...
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...resources and give value for money. Within the community care district nurses are vital, there role is autonomous, unique and varied. Furthermore there expert theory, skills, and knowledge of self and practice adds to their advanced interpersonal communication skills to assess clients with increasing complex needs (Blazor et al 2008). Communication is the cornerstone of the nurse patient therapeutic relationship and is the essence of good care (Stein-Parbury, 2009). Within the community care setting, therapeutic relationships are a high priority of the health service to enhance the well-being of the growing ageing population and patients with complex palliative care needs (Bain and Baguley 2012). The Department of Health (2006) acknowledges that communication is paramount for human interaction, otherwise people cannot relate to others effectively, make their needs known and identify what is happening to them. A fundamental aspect for district nursing staff is to ensure the whole family unit is included in the communication process which is an essential part of the therapeutic relationship. The therapeutic relationship is grounded in an interpersonal process that occurs between the nurse and the client. It is a purpose, goal directed relationship that is directed at advancing the best interest and outcome of the...
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...Case 1: Review the following case study. Discuss each point of motivational interviewing, why it was used, and whether or not it was successful. What was done well in this interview, and why? What would you have done differently, and why? Of the theories we have learned in this unit, which theory stands out in this interview? Where and how? “A client-centered and empathetic counseling style is one fundamental and defining characteristic of motivational interviewing. We regard the therapeutic skill of reflective listening or accurate empathy ... to be the foundation on which skillfulness in motivational interviewing is built ... Through skillful reflective listening, the counselor seeks to understand the client’s feelings and perspectives without judging, criticizing, or blaming ... The crucial attitude is a respectful listening to the person with a desire to understand his or her perspective” (Miller & Rollnick, 2002, p. 37) In this case, the Motivational interviewing refers to an interpersonal counseling or communication style rather than a specific therapy or set of techniques (Rollnick & Miller, 1995). This style is evident in the process of MET (Motivational Enhancement Therapy). The focus of this particular interview was on helping the client to overcome reluctance or ambivalence on his own, while allowing him to make positive changes in his approach to anger management. The therapy did not assume that the client wanted to change, but lead the client to own their need...
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...Introduction Davies and Bhugra (2004) noted that, the humanistic and cognitive-behaviour approaches to therapy share little more than a resounding belief in the need for a strong therapeutic alliance to affect positive and lasting change in behaviour, thoughts and attitude of clients seeking therapeutic intervention. The difference lies in the application of the techniques and the beliefs underlying the origins and treatment of psychological problems, which are associated with the physical illness and biological abnormalities of one sort or another. (Davies, and Bhugra2004). According to Barker (2003) a therapeutic alliance is a situation in which patient and psychotherapists are bound together in working towards mutual communication and understanding. This means that the professional hopes to engage with and effect change in a patient. In addition, Gabbard (1994) noted that the essence of therapy is a transaction between two collaborating human beings with the goal of helping the patients, and that there is no right treatment approach. Different theoretical models and treatments strategies may apply flexibly over the course of treatment. This essay will compare and contrast humanistic approach and cognitive behaviour approach, and discuss their relevance to psychiatric nursing practice. Both approaches will be applied to the management of anxiety. The humanistic approach According to Bugental (1967), the humanistic approach is concerned with the...
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...part of the therapeutic dynamic (Sheperis, D. S., & Ellis, C. M., 2010).” Counselor’s characteristics are formed by one’s personality and how that counselor uses his or her personality in their approaches to therapy. In the media Counselor Characteristics, Gail Mear, Bob Walsh and Norm Dasenbrook all explained a few counselor characteristics they believed are used during therapy. Some of those characteristics that are effective are being that helping person (through this with training a counselor gains a skill set to help the client), setting boundaries (being able to know when to set limits in counseling between you as the counselor and your client), empathic counselor (being able to understand your clients feelings and grasp where those feelings are coming from), Self-Awareness (counselors encourage clients though process of belief that they can achieve anything, have faith in the clients you work with but also be aware that not everything they tell you is the truth), lastly collaboration (by working together as a system and using your people skills your collaboration with your client will be more effective). An ineffective characteristic that I got from the media was codependency, making sure to pay attention to times when counselors become too involved in their clients therapy or lives and are not creating the active listening environment, this may lead to not helping the client heal and become a more positive person and get better in the long run. In the case study two effective...
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