learning Objectives - Describe therapeutic relationship Demonstrate skills in process recording
Hours - 5
Teaching and Learning Activities - Lecture cum discussions Role play Videos Demonstration of process recording
Assessment Methods - Short answers Return demonstration
Content of the chapter
a) Therapeutic nurse patient relationship:
Definition, components and phases,
Importance
b) Communication skills Definition elements,
types, factors influencing communication,
barriers (therapeutic impasse)
The therapeutic nurse–patient relationship is the foundation of psychiatric and mental health nursing. It is a professional, goal-oriented relationship that focuses on the patient’s needs and promotes healing, growth, and recovery.
a) Therapeutic Nurse–Patient Relationship
Definition
A therapeutic nurse–patient relationship is a planned, professional, interpersonal process in which the nurse uses self, communication skills, and nursing knowledge to help the patient achieve positive mental health outcomes.
Components of Therapeutic Relationship
- Trust
- Patient feels safe and secure
- Nurse is honest and reliable
- Respect
- Acceptance without judgment
- Recognition of patient’s dignity
- Empathy
- Understanding patient’s feelings and experiences
- Professional boundaries
- Clear role limits
- Avoid over-involvement
- Confidentiality
- Protection of patient’s information
- Genuineness
- Being real, sincere, and consistent
Phases of Therapeutic Relationship
- Pre-interaction Phase
- Nurse prepares self
- Reviews patient records
- Identifies personal feelings and biases
- Orientation Phase
- First meeting
- Establishes trust
- Explains roles, purpose, time, and boundaries
- Identifies patient problems
- Working Phase
- Longest phase
- Patient explores feelings and behaviors
- Nurse implements interventions
- Promotes insight and coping skills
- Termination Phase
- Relationship ends
- Evaluation of goals achieved
- Encourages independence
- Feelings of separation addressed
Importance of Therapeutic Nurse–Patient Relationship
- Facilitates accurate assessment
- Enhances patient trust and cooperation
- Promotes expression of feelings
- Improves treatment compliance
- Reduces anxiety and fear
- Supports recovery and rehabilitation
- Enhances patient satisfaction
b) Communication Skills
Definition
Communication is the process of exchanging information, ideas, thoughts, and feelings between individuals through verbal and non-verbal means.
Elements of Communication
- Sender
- Message
- Channel
- Receiver
- Feedback
- Context
Types of Communication
- Verbal Communication
- Spoken or written words
- Non-verbal Communication
- Facial expressions, gestures, posture, eye contact
- Therapeutic Communication
- Purposeful, patient-centered interaction
- Intrapersonal Communication
- Communication within self
- Interpersonal Communication
- One-to-one communication
Factors Influencing Communication
- Emotional state
- Cultural background
- Language differences
- Educational level
- Physical illness
- Mental status
- Environment (noise, privacy)
Barriers to Communication (Therapeutic Impasse)
Therapeutic impasse refers to blocks in effective nurse–patient communication that hinder therapeutic progress.
Common Barriers:
- Personal Barriers
- Nurse’s anxiety
- Bias or prejudice
- Lack of self-awareness
- Psychological Barriers
- Fear, anger, mistrust
- Delusions or hallucinations
- Environmental Barriers
- Noise
- Lack of privacy
- Communication Technique Barriers
- Giving advice
- Changing the subject
- Asking “why” questions
- False reassurance
- Minimizing patient’s feelings
- Cultural and Language Barriers
- Misinterpretation
- Different beliefs
Conclusion
A therapeutic nurse–patient relationship combined with effective communication skills is essential for quality mental health care. Understanding the phases of the relationship, maintaining professional boundaries, and overcoming communication barriers help nurses provide holistic, empathetic, and patient-centered care.