UNIVERSIDAD de MANILA
One Mehan Gardens, Ermita, Philippines
THERAPEUTIC COMMUNICATION TECHNIQUE
TECHNIQUE
Using Silence
Providing General Leads
Being Specific and Tentative
Using Open-ended Question
Using Touch
Restating or Paraphrasing
Seeking Clarification
DESCRIPTION EXAMPLES
Accepting pauses or silence that may Sitting quietly (or walking with the
extend for several seconds or minutes client) and waiting attentively until the
without interjecting any verbal client is able to put thoughts and
response feelings into words
Using statements or questions that (a). Can you tell me how it is for you?
encourage the client to verbalize, (b). Perhaps you would like to talk about…
choose a topic of conversation, and (c). Would it help to discuss your feelings?
facilitate continued verbalization Where would you like to begin?
And then what?
Making statement that are specific Rate your pain on scale 0 - 10 (specific
rather than general, and tentative statement)
rather than absolute Are you in pain? (general statement)
You seem unconcerned about your
diabetes (tentative statement)
You don’t care about you
Asking broad question that lead or I’d like to hear more about that
invite the client to explore (elaborate, Tell me about…
clarify, describe, compare or illustrate) How have you been feeling lately?
thoughts or feelings. Open-ended What brought you to the hospital?
questions the topic to be discussed and What is your opinion?
invite answer that is longer than one or
two words
Providing appropriate forms of touch to Putting an arm on client’s shoulder
reinforce caring feelings. Because Placing your hands over the client’s
tactile contacts vary considerably hand
among individuals, families, and
cultures, the nurse must be sensitive to
the differences in attitude and practices
of client and self.
Actively listening to the client’s Client: I couldn’t manage to eat dinner
message and then repeating those last night not even the dessert
thoughts and/or feelings in similar Nurse: You have difficulty eating last
words. This conveys that the nurse has night
listened and understood the client’s Client: Yes, I was very upset after my
basic message and also offers clients a family left
clearer idea of what they have said Nurse: You were upset when your
family left
Client: I have trouble talking to
strangers
Nurse: You find it difficult talking to
people you do not know
A method of making the client’s broad I’m puzzled
over all meaning of the message more I’m not sure I understand that, would
understandable. It is used when you please say that again
paraphrasing is difficult or when the I meant this, rather than that
communication is rambling or garbled. I’m sorry that wasn’t very clear. Let
To clarify the message, the nurse can me try to explain another way
restate the basic message or confess
confusion and ask the client to repeat
or restate the message. Nurses can also
clarify their own message with
 statements
Seeking Consensual Validation A method similar to clarifying that
verifies the meaning of specific words
rather than the overall meaning of a
message
Suggesting one’s presence, interest, or
Offering Self wish to understand the client without
making any demands or attaching
conditions that the client must comply
with to receive the nurse’s attention
Giving Information Providing in a simple and direct
manner, specific factual information the
client may or may not request. When
information is not known, the nurse
state this and indicates who has it or
when the nurse obtain it.
Acknowledging Giving recognition, in a non-judgmental
way, of a change in behavior, an effort
the client has made, or a contribution
to a communication.
Acknowledgement may be with or
without understanding, verbal or
nonverbal.
Clarifying Time and Sequence Helping the client clarify an event,
situation, or happening in relationship
to time
Presenting Reality Helping the client to differentiate the
real from the unreal
Helping the client expand on and
develop a topic of importance. It is
Focusing important for the nurse to wait until the
client finishes stating the main concerns
before attempting to focus. The focus
may be an idea or a feeling; however,
the nurse often emphasizes a feeling to
help the client recognize an emotion
disguised behind words.
Directing ideas, feelings, questions, or
content back to client to enable them
Reflecting to explore their own ideas and feelings
about a situation
Stating the main points of a discussion
to clarify the relevant points discussed.
Client: My husband never give me any
present.
Nurse: You mean he has never given
you a present for your birthday or
Christmas?
Client: Well, not never. He does get
me something for my birthday and
Christmas but he never thinks of giving
anything at any given time.
I’ll stay with you until your daughter
arrives.
We can sit here quietly for a while; we
don ‘t need to talk unless you would
like to
I’ll help you to dress or go home if you
like
Your surgery is scheduled for 11 AM
tomorrow.
You will feel a pulling sensation when
the tube is removed from your
abdomen.
You trimmed your beard and
mustache and wash your hair
I notice you keep squinting your eyes.
Are you having difficulty seeing?
You walked twice as far as today with
your walker
Client: I vomited this morning
Nurse: Was that after breakfast?
Client: I feel that I have been asleep
for weeks
Nurse: You had your operation
Monday, and today is Tuesday
That telephone ring came from the
program in television
I see shadows from the windows
coverings
Your magazine is here in the drawer. It
has not stolen
Client: My wife says she will look after
me, but I don’t think she can,what
with the children to take care of, and
they’re always after about something,
clothes, homework, what’s for dinner
last night.
Nurse: Sounds like you are worried
about how well she can manage.
Client: What can I do?
Nurse: What do you think would be
helpful?
Client: Do you think I should tell my
husband?
Nurse: You seem unsure about telling
your husband
During the past half hour we have
talked about…
 Summarizing and Planning This technique is useful at the end of an
interview or to review a health teaching
session. It often acts as introduction to
future care planning
BARRIERS TO COMMUNICATION/NON-THERAPEUTIC COMMUNICATION
TECHNIQUE DESCRIPTION
Offering generalized and over
STEREOTYPING simplified beliefs about group of
people that are based on experiences
too limited to be valid. These
responses categorize clients and
negate their uniqueness as
individuals
Akin to judgmental responses,
agreeing and disagreeing imply that
AGREEING AND DISAGREEING the client is either right or wrong and
the nurse is in the position to judge
this. This responses deter clients
from thinking trough their position
and may cause a client to become
defensive
Attempting to protect a person or
health care services from negative
comments. These responses prevent
BEING DEFENSIVE the client from expressing true
concerns. The nurse is saying, You
have no rights to complain. Defensive
Tomorrow afternoon, we may explore
this further
In few days I’ll review what you have
learned about the actions and effects
of your insulin
Tomorrow I will look at your feeling
journal
EXAMPLES
Two year old are brats
Women are complainers
Men don’t cry
Most people don’t have any pain
after this type of surgery
Client: I don’t think Dr. Kitty is a very
good doctor. He doesn’t seem
interested in her patients.
Nurse: Dr. Kitty is the head of the
surgery and is an excellent surgeon
Client: Those night nurses must just
sit around and talk all night. They
didn’t answer my light for even an
hour.
Nurse: I’ll have you know we literally
run around on nights. You’re not the
 responses protect the nurse
admitting weaknesses in the health
care services, including personal
weaknesses.
Giving a response that makes clients
prove their statement or point of
view. These responses indicates that
CHALLENGING the nurse is failing to consider the
client’s feelings, making the client
feel it necessary to defend a position.
Asking for information chiefly out of
curiosity rather than with the intent
PROBING to assist the client. These responses
are considered prying and violate the
client’s privacy. Asking why, is often
probing and places the client in a
defensive position.
Asking the question that makes the
TESTING client admit to something. These
responses permit the client only
limited answer and often meet the
nurse’s need rather than the clients.
Refusing to discuss certain topic with
the client. These responses often
REJECTING make client feel that the nurse is
rejecting not only their
communication but also the clients
themselves.
Directing the communication into
areas of self-interest rather than
considering client’s concern is often a
CHANGING TOPICS AND SUBJECTS self-protective response to a topic
that causes anxiety. These responses
imply what the nurse considers
important will be discussed and the
clients should not discuss certain
topics.
Using clichés or comforting
UNWARRANTED REASSURANCE statements of advice as a means to
reassure the client. These responses
block the fears, feelings, and other
thoughts of the clients.
Giving opinions and approving and
PASSING JUDGMENT disapproving responses, moralizing,
or implying one’s own values. These
responses imply that the client must
think as the nurse thinks, fostering
client dependence
Telling the client what to do.
GIVING COMMON ADVICE These responses deny the client’s
right to be an equal partner. Note
that giving expert rather than
common advice is therapeutic
only client, you know.
Client: I felt nauseated after those
red pills.
Nurse: Surely you don’t think I gave
you the wrong pill?
Client: I feel as if I am dying
Nurse: How can you feel that way
when your pulse is 60?
Client: I believe that my husband
doesn’t love me
Nurse: You can’t say that; Why, he
visits you every day?
Client: I was speeding along the
street and didn’t see the stop sign.
Nurse: Why were you speeding?
Client: I don’t ask the doctor when he
was here.
Nurse: Why don’t you?
Who do you think you are? (forces
people to admit their status is only
that of client)
Do you think I am not busy?
(forces the client to admit that the
nurse really is busy)
I don’t want to discuss that
Let’s talk about…
Let’s discuss other areas of interest
to you rather than the two problems
you keep mentioning
I can’t talk now. I’m on my way to
coffee break.
Client: I’m separated from my wife.
Do you think I should have sexual
relations with other woman?
Nurse: I see that you’re 36 and that
you like gardening. This sunshine is
good for my roses. I have a beautiful
rose garden.
You’ll feel better soon.
I’m sure everything will turn out all
right.
Don’t worry.
That’s good (bad)
You shouldn’t do that.
That’s not good enough.
What you did was wrong (right).
Client: Should I move from my home
to a nursing home?
Nurse: If I were you, I’d to a nursing
home, where you’ll get your meals
cooked for you.