Therapeutic Communication - Walla Walla Community College



Therapeutic Communication

Competency #4-A, Use of Therapeutic Communication

Therapeutic communication, as expected for Competency 4-A in Level II, is more than just using therapeutic communication techniques in a conversation – it is interventional. That is, it is purposeful; with a clear, measurable expected outcome. It is based directly on the Nursing Process.

When completing your competency performance self-evaluation (Competency #4-A), include 4 headings, one for each criterion, and pay strict attention to the following guidelines:

Criterion #1:

This criterion asks you to provide a scenario; this includes the first two components of the nursing process: Assessment and Analysis; include a sub-heading for each.

Assessment: Here you must present all the pertinent data you collected – both subjective and objective – that supports the problem you will identify in the next section. This is where you present what you saw and heard that led you to a conclusion about the client’s condition.

Analysis: Here you must demonstrate critical thinking by analyzing the data and drawing a conclusion about what the problem may be. The problem identified must be related to an emotional state, e.g., anxiety, fear, depression, anger, etc., and include a “related to” component, which is the rationale for or the probable cause of the emotional state. For example, “fear related to impending surgery”.

Note: This is not a knowledge deficit, that is, this is not simply a client who needs “information”.

Criterion #2:

Plan: In developing a plan to help your client, you must clearly identify what is the goal (expected outcome) of your interventions. Expected outcomes must be patient-oriented, not nurse-oriented; that is, they must start with “Patient will…” not something like, “To help the patient…” In addition, all expected outcomes must have a measurable component; clearly identify the objective and/or subjective evidence (measurable criteria) that will allow you to know if you achieved your expected outcome. In developing an expected outcome consider their current emotional state and what you hope to achieve after using purposeful, interventional communication.

If a patient is currently: When you conclude, patient will be:

Angry Calm, rational, controlled

Fearful /Afraid Unafraid, accepting of situation

Anxious Calm, tranquil, content

Depressed/Sad Positive, unburdened, satisfied, cheerful

Criterion #3:

Intervention: The intervention of Therapeutic Communication is a twofold process: (1) the patient expresses his/her thoughts and feelings, and (2) the nurse uses therapeutic communication techniques to guide the conversation toward the desired or expected outcome. (Notice that having the patient express their feelings is not the expected outcome, but instead is part of the interventional process of therapeutic communication.)

In this section you must provide (1) a minimum of three examples of statements you made as part of your interventional communication, (2) for each example, identify the type of therapeutic technique utilized (in parentheses), and (3) the patient’s response to each of your interventional statements. (A list of therapeutic communication techniques has been attached for your convenience.)

Criterion #4:

Evaluation: In this section you must directly consider your expected outcome and identify (1) if you did or did not achieve the expected outcome, and (2) provide the objective evidence that supports your conclusion, i.e., how specifically you met the expected outcome. Speak to the measurable criteria you identified in your expected outcome. Finally, consider in retrospect what modifications or changes you would like to have made in your communication to be more effective in assisting your client in achieving the desired or expected outcome.

Be honest in your evaluation; not all efforts at therapeutic communication go as planned; do not be afraid to identify examples of non-therapeutic communication you used, with your analysis of why it was non-therapeutic and what you would do differently to improve.

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