Therapeutic communication ain’t so easy

One of the more challenging subjects for me when it comes to test-taking are the questions revolving around therapeutic communication. I think it’s mostly because when we look at the range of topics we have to cover, we see therapeutic communication as something “easy” since we all communicate every day. And unless we’ve had some bad relationships lately because we can’t quite figure out to say, we feel like figuring out what to say to someone and when, isn’t our number one priority when we’re studying.
Regardless, therapeutic communication is a big part of our lives as nurses, and a significant chunk of the NCLEX.  We have to know when to say what and how to say it. Sometimes, when going over test rationales, I feel like the correct answer was the one I was least likely to pick. Therapeutic communication is not a part of our every day lives until we practice it! We had a whole class devoted to it in our first year, all about interviewing patients and learning ask open ended sentences, leading cues, and feedback to help the client or patient feel comfortable with sharing.

I really don’t feel like there is one “right” way to study for therapeutic communication questions.  Sometimes they’re tricky, especially in psych when the answers that were once commonplace, are now indicators of a big problem! There are a few things to keep in mid, however, and hopefully they will help!

1) Be an Active Listener – Always be attentive, observe their nonverbal behavior and listen for underlying cues they may be giving you. Are they being consistent?

2) Provide feedback – Let them know you are paying attention, clarify what you don’t quite understand, and summarize what you have understood.

3) Silence is OK – Our society doesn’t really let us take breaks in conversations we have with people we barely know, silence is only something we are comfortable with when we are close to someone, and even then, not so much. If the client isn’t continuing or answering right away, be ok with it and give them time to think.

4) Be culturally sensitive – Remember that different cultures have different norms for communicating. Be aware of what beliefs your client might practice and be respectful.

5) Never ever EVER say you know what they’re feeling – “I know this is hard for you,” and “I know how you feel” are not the right answer (at least in my experience). You might have had a similar experience, but you are not this person, in this situation, under these circumstances, and at this point in time. You do not know what they are going through, and it’s not ok for you to talk about when you went through something just like it, whether you have personally, or your aunt Sally did 15 years ago. It’s not the same thing.

There are so many dimensions to therapeutic communication, it’s hard to just say “this is correct,” or this is how to answer this, because ever question will present with a different patient. And that is the crux of therapeutic communication, it is different for every patient. So keep these tips in mind, remember that you want the most unbiased, caring, yet honest and professional answer possible, and good luck!