PSYCHIATRIC

NURSING
THERAPEUTIC / NON THERAPEUTIC
COMMUNICATION
Therapeutic Communication

1.Using SILENCE
Nursing Action : Sit Quietly, while

attentive to the patient

 Listen attentively, while the
patients talks without
attempting to compete with
him
 Remain silent until the patient
calms down
 Situation :
Patient upset and crying
uncontrollably

 Nurse Action : Remain silent

until the patient can gain control
over his or her feelings
2. ACCEPTING

 Nursing Action : “ I will stay with

you.”

 Nurse option : “It sounds as if

you are both upset.”
3. GIVING RECOGNITION

 NURSE:
 “ I see that you have changed
your dress and combed your
hair before coming to breakfast.”

 “ You have painted a picture.”

4. MAKING OBSERVATIONS

 Nurse :
 “ You seem very concerned
about something this morning.”

 “You seem quiet this evening.”

 “You are touching my knee with

your hand.”
5. OFFERING SELF

 Nurse :

 “I will stay with you for a while.”

 “Its time to go to your therapy, I

will go with you.”
6. REFLECTING

 Situation : Patient angry and

demands his breakfast. The
nurse had observed the patient
eating that morning.
 Nurse: “ You seem hungry. It
has been several hours since
you had breakfast. Come, let
me give you some tea or milk.”
 Situation : Patients states
angrily that he or she is now the
head nurse and everyone must
follow his directions.

 Nurse : “ You seem angry when

you talk about being a nurse.”
 Patient : “ Who do you people
think you are, forcing patients to
work like this? How dare you?

 Nurse : “ You sound furious

about your assignment.”
7. RESTATING
Patient : “ The aide slept all night
long. I know because I watched
him sleep.”
 Nurse: “You seem to have
difficulty sleeping at night.”
Patient : “I’ve messed up my life,
my job, and my love life. I’m just
going to make a new
beginning.”
 Nurse : You’re saying that your
experiences have been
8. GIVING INFORMATION

 Nursing Action: SHORT,

SIMPLE DIRECTIONS. BRIEF,
CONCISE EXPLANATION.
 Patient: “My arms don’t feel like a
part of me. What could this strange
feeling be caused by and when will it
go away?”
 Nurse: “This strange feeling you
have concerning your arms is a a
part of your illness. It will go away as
you become better.”
 Nurse: You seemed confused, I am
your nurse, You are in the
Metropolitan Psychiatric Institute.
9. PRESENTING REALITY
 Patient: “I am hearing voices
calling me filthy names.”
 Nurse: “I don’t hear voices. You

sound as if you are frightened.”

 Patient: “I demand a trial. I
cannot be executed without
trial.”
 Nurse: “You are not going to be
executed. You seem
frightened.”
10. REDIRECTING

 Patient: “ Nurse, you look very

tired.”

 Nurse: “ Yes, I am tired. We are

busy discussing your feelings
about the staff.”
 NON THERAPEUTIC
COMMUNICATION
 REASSURING

 Patient : “Everyone here wants

to see me dead.”
 Nurse : “ This is a hospital.
The staff is here to help you
and protect you from all harm.”
 Patient : “ I see my Doctor
everyday. How can you help me
to get back my memory?”
 Nurse : “I understand exactly
what you are feeling. You’ll find
our talks will help you.”
 Patient : “I refuse to take those
psychological exams, why
should I take anyway?”
 Nurse : “It will help you to get
better and you will be able to go
home sooner.”
2. GIVING APPROVAL

 NURSE: “ Oh, you look

beautiful. I like your new dress.”

 “ You have done a good job.”

3. REJECTING
 Situation: The nurse/patient
approach in 2 persons parallel
another patient joins them,
where shall the nurse sit?
 Inappropriate action: The nurse
sitting on the other side of the
new patient
 Nurse: “ I see that you are quite
anxious and upset so I will leave
you alone.”
4. DISAPPROVING

 Nurse : Gently Inquire from the

patient, “How could you say
such a thing to me?”
5. AGREEING

 Patient: “ You know that the

President invited me to the
White House,”
 Nurse: “Have you decided to
accept the invitation?”
6. DISAGREEING
 Patient: “ The aide slept all night
long. I watched her sleep.”
 Nurse: “ That’s hard to believe,
but I will look into it.”
 Patient: “I hear voices calling
me dirty names.”
 Nurse: “ You only think that you
hear voices. Its all in your
imagination.
7. ADVISING

 Nurse: “ I think it would be a

good idea for you to go home on
a weekend pass,”

 Nurse: “ Therapy is very nice.

Why don’t you give it a try?”
8. PROBING

 Nurse: “Why did you……….”

 Nurse: “ When did you……..”

9. GIVING INFORMATION

 Inappropriate Action: Giving

detailed, scientific explanation.

10. THREATENING
 Nurse: “If you don’t eat, we will
be forced to tube feed you.”
11. REINFORCING

 Nurse: “Since you claim that

your arm is paralyzed, and can’t
dial the phone, I’ll call your wife
for you.”
 Nurse: “I know that you are
afraid of having a heart attack,
so I’ll listen to your heart and
take your pulse frequently.”