Using Silence
Gives the client the opportunity to collect
and organize thoughts, to think through
a point, or to consider introducing a
topic of greater concern than the one
being discussed.
Using Silence
Therapeutic
Accepting
Therapeutic
Giving Recognition
Therapeutic
Offering Self
Therapeutic
Giving Broad Openings
Therapeutic
Offering General Leads
Therapeutic
Placing the Event in TIme or Sequence
Therapeutic
Making Observations
Therapeutic
Encouraging Description of Perceptions
Therapeutic
Encouraging Comparison
Therapeutic
Restating
Therapeutic
Reflecting
Therapeutic
Focusing
Therapeutic
Exploring
Therapeutic
Seeking Clarification and Validation
Therapeutic
Presenting Reality
Therapeutic
Voicing Doubt
Therapeutic
Verbalizing the Implied
Therapeutic
Attempting to Translate Words into Feelings
Therapeutic
Formulating a Plan of Action
Therapeutic
Giving Reassurance
Non-Therapeutic
Rejecting
Non-Therapeutic
Approving or disapproving
Non-Therapeutic
Agreeing or Disagreeing
Non-Therapeutic
GIving Advice
Non-Therapeutic
Probing
Non-Therapeutic
Defending
Non-Therapeutic
Requesting an Explanation
Non-Therapeutic
Indicating the Existence of an External Source of Power
Non-Therapeutic
Belittling Feelings Expressed
Non-Therapeutic
Making Stereotyped Comments
Non-Therapeutic
Using Denial
Non-Therapeutic
Interpreting
Non-Therapeutic
Introducing an Unrelated Topic
Non-Therapeutic
Accepting
Conveys an attitude of reception and
regard.
Accepting
Yes, I understand what you said."
Eye contact; nodding.
Acknowledging; indicating awareness; better than complimenting, which reflects
the nurse's judgment.
Giving Recognition
I see you made your bed.
Giving Recognition
Making oneself available on an unconditional basis, increasing client's feelings of
self-worth.
Offering Self
I'm interested in you.
Offering Self
Allows the client to take the initiative in introducing the topic; emphasizes the importance of the client's role in the interaction.
Giving Broad Openings
What would you like to talk about
today?
Giving Broad Openings
Offers the client encouragement to
continue.
Offering General Leads
Go on.
Offering General Leads
Clarifes the relationship of events in time so that the nurse and client can view them in perspective.
Placing the Event in Time or Sequence
What seemed to lead up to . . .?
Placing the Event in Time or Sequence
Verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and compare perceptions with the nurse.
Making Observations
You seem tense.
Making Observations
Asking the client to verbalize what is being perceived; often used with clients experiencing hallucinations.
Encouraging Description of Perceptions
Tell me what is happening now.
Encouraging Description of Perceptions
Asking the client to compare similarities and differences in ideas, experiences, or interpersonal relationships. This helps the client recognize life experiences that
tend to recur as well as those aspects of life that are changeable.
Encouraging Comparisons
How does this compare with the time when . . .?
Encouraging Comparisons
Repeating the main idea of what the client has said. This lets the client know whether or not an expressed statement has been understood and gives him or her the chance to continue, or to clarify if necessary.
Restating
Client: "I can't study. My mind keeps
wandering."
Nurse: "You have trouble concentrating.
Restating
Questions and feelings are referred back to the client so that they may be recognized and accepted, and so that the client may recognize that his or her point of view has value�a good technique to use when the client asks the nurse for advice.
Reflecting
Client: "What do you think I should do about my wife's drinking problem?"
Nurse: "What do you think you
should do?
Reflecting
Taking notice of a single idea or even a single word; works especially well with a client who is moving rapidly from one thought to another. This technique is not therapeutic, however, with the client who is very anxious. Focusing should not be pursued un
Focusing
This point seems worth looking at more closely. Perhaps you and I can discuss it together.
Focusing
Delving further into a subject, idea,
experience, or relationship; especially helpful with clients who tend to remain on a superf cial level of communication. However, if the client chooses not to disclose further information, the nurse should refrain fro
Exploring
Striving to explain that which is vague or incomprehensible and searching for mutual understanding; clarifying the meaning of what has been said facilitates and increases understanding for both client and nurse.
Seeking Clarification and Validation
I'm not sure that I understand. Would you please explain?
Seeking Clarification and Validation
When the client has a misperception of the environment, the nurse defines reality or indicates his or her perception of the situation for the client.
Presenting Reality
I understand that the voices seem real to you, but I do not hear any voices.
Presenting Reality
Expressing uncertainty as to the reality of the client's perceptions; often used with clients experiencing delusional thinking.
Voicing Doubt
I understand that you believe that to be true, but I f nd it hard to accept.
Verbalizing the Implied
Putting into words what the client has only implied or said indirectly; can also be used with the client who is mute or is otherwise experiencing impaired verbal communication. This clarifies that which is implicit rather than explicit.
Attempting to translate words into feelings
Client: "It's a waste of time to be here. I can't talk to you or anyone."
Nurse: "Are you feeling that no one understands?
Attempting to translate words into feelings
When a client has a plan in mind for
dealing with what is considered to be
a stressful situation, it may serve to
prevent anger or anxiety from escalating to an unmanageable level.
Formulating a plan of action
What could you do to let your anger out harmlessly?
Formulating a plan of action
Tell me more about that particular
situation.
Exploring