ICBS 120ICBS 120

THERAPEUTIC THERAPEUTIC COMMUNICATIONSCOMMUNICATIONS

Why is Communication in Why is Communication in Healthcare Important?Healthcare Important?

1. It is something we do every day as 1. It is something we do every day as

healthcare professionals.healthcare professionals.

2. It serves as the foundation for all 2. It serves as the foundation for all

patient care.patient care.

3. Patient’s can read how we 3. Patient’s can read how we

communicate both verbally and communicate both verbally and

through our body language.through our body language.

Therapeutic CommunicationTherapeutic Communication

Introduces an element of empathy.Introduces an element of empathy. Imparts a feeling of comfort.Imparts a feeling of comfort. Patient feels valued and respected.Patient feels valued and respected. Is the FOUNDATION of all patient care.Is the FOUNDATION of all patient care. When communicating with a patient, it When communicating with a patient, it

is important to speak with them in is important to speak with them in terms they understand.terms they understand.

Be aware of cultural influences.Be aware of cultural influences.

Biases and PrejudicesBiases and Prejudices

Affect the types of communication Affect the types of communication possible; attitudes may become possible; attitudes may become hostile.hostile.

Bias:Bias: Slant toward a particular beliefSlant toward a particular belief

Prejudice:Prejudice: Defined as an opinion/judgement that is Defined as an opinion/judgement that is

formed before all facts are known.formed before all facts are known.

Common Biases and PrejudicesCommon Biases and Prejudices

1.1. A preference for Western style medicine.A preference for Western style medicine.2.2. Choosing a physician according to Choosing a physician according to

gender.gender.3.3. Prejudice related to a person’s sexual Prejudice related to a person’s sexual

preference.preference.4.4. Discrimination based on race or religion.Discrimination based on race or religion.5.5. Hostile attitudes toward people with Hostile attitudes toward people with

different values.different values.6.6. Those who cannot afford healthcare Those who cannot afford healthcare

should receive less or no treatment.should receive less or no treatment.

The Communication CycleThe Communication Cycle

Includes four basicIncludes four basic

elements:elements:

1.1. The senderThe sender

2.2. Message and Message and mode of messagemode of message

3.3. The receiverThe receiver(decode or interpret)(decode or interpret)

4.4. FeedbackFeedback

Sender Message

ReceiverFeedback

Listening SkillsListening Skills

A vital part of feedback in the A vital part of feedback in the communication cycle.communication cycle.

Active listening: Active listening: – Be aware of what patient is saying and NOT Be aware of what patient is saying and NOT

saying.saying.– Make certain you heard their message Make certain you heard their message

correctly.correctly.

Verbal CommunicationsVerbal Communications

Takes place when a message is Takes place when a message is

spoken.spoken.

The Five C’s of Communication:The Five C’s of Communication:

1.1. Complete Complete

2.2. ClearClear

3.3. ConciseConcise

4.4. CourteousCourteous

5.5. CohesiveCohesive

Nonverbal CommunicationNonverbal Communication

Body Language:Body Language: unconscious unconscious movements of the body, gestures, movements of the body, gestures, and facial expressions.and facial expressions.

Kinesics: study of body language.Kinesics: study of body language.– 70% of communication is nonverbal70% of communication is nonverbal– 23% is based on tone of voice23% is based on tone of voice– 7% is actually spoken words7% is actually spoken words

LanguageLanguage

Facial ExpressionFacial Expression Territoriality/personal space: distance we feel Territoriality/personal space: distance we feel

comfortable with others while communicating.comfortable with others while communicating. Posture:Posture: manner in which we carry ourselves. manner in which we carry ourselves. Position:Position: physical stance of two individuals physical stance of two individuals

while communicating. while communicating. TouchTouch

Congruency in CommunicationCongruency in Communication

Verbal and nonverbal messages must Verbal and nonverbal messages must agree.agree.

Clustering:Clustering: grouping of nonverbal grouping of nonverbal messages into statements or conclusions.messages into statements or conclusions.

Masking:Masking: attempt to concreal or repress attempt to concreal or repress true feeling or message.true feeling or message.

Perception:Perception: conscious awareness of one’s conscious awareness of one’s own feelings and the feelings of others.own feelings and the feelings of others.

Maslow’s Hierarchy of NeedsMaslow’s Hierarchy of Needs

Abraham Maslow is the founder of Abraham Maslow is the founder of humanistic psychologyhumanistic psychology

According to the Hierarchy, each According to the Hierarchy, each level of need must be satisfied level of need must be satisfied before one can move to the next before one can move to the next level.level.

Hierarchy facilitates therapeutic Hierarchy facilitates therapeutic communicationscommunications

Self-Self-ActualizationActualization

Prestige & Prestige & Esteem needsEsteem needs

Belongingness and Belongingness and Love NeedsLove Needs

SafetySafety Needs Needs

Survival or Physiological NeedsSurvival or Physiological Needs

Hierarchy of Needs Cont’dHierarchy of Needs Cont’d

Level 1=physiologicLevel 1=physiologic (food, water, air) (food, water, air)Level 2=safety and securityLevel 2=safety and security (security, (security, stability, and protection)stability, and protection)Level 3=belonging and loveLevel 3=belonging and love (giving (giving and receiving of affection)and receiving of affection)Level 4=prestige and esteemLevel 4=prestige and esteem (stable, (stable, healthy self-respect for ourselves healthy self-respect for ourselves and each other.and each other.Level 5=self-actualizationLevel 5=self-actualization (at peak, doing (at peak, doing what truly fits us in life)what truly fits us in life)

Defense MechanismsDefense Mechanisms

Behavior that is used to protect egoBehavior that is used to protect ego

from guilt, anxiety, or loss of esteem.from guilt, anxiety, or loss of esteem.

Regression:Regression: attempt to withdraw from attempt to withdraw from unpleasant circumstance by retreating to unpleasant circumstance by retreating to an earlier, more secure stage of life.an earlier, more secure stage of life.

Denial:Denial: is refusal to accept painful is refusal to accept painful information that is readily apparent to information that is readily apparent to others.others.

Defense Mechanisms cont’dDefense Mechanisms cont’d

Repression:Repression: similar to denial similar to denial (unconscious)(unconscious)

Projection:Projection: attributing unacceptable attributing unacceptable desires, impulses, and thoughts falsely to desires, impulses, and thoughts falsely to others to avoid acknowledging they are others to avoid acknowledging they are actually the person’s own experiences actually the person’s own experiences (sign of mental illness)(sign of mental illness)

Sublimation:Sublimation: channeling of a socially channeling of a socially unacceptable behavior into an unacceptable behavior into an acceptable behavior.acceptable behavior.

Defense Mechanisms cont’dDefense Mechanisms cont’d Displacement:Displacement: unconscious transfer of unacceptable unconscious transfer of unacceptable

emotions, thoughts, or feelings from one’s self to a more emotions, thoughts, or feelings from one’s self to a more acceptable external substitute.acceptable external substitute.

Compensation:Compensation: conscious or unconscious over- conscious or unconscious over-emphasizing of a characteristic to offset a real or emphasizing of a characteristic to offset a real or imagined deficiency.imagined deficiency.

Rationalization:Rationalization: the mind’s way of making unacceptable the mind’s way of making unacceptable behavior or events acceptable by devising a rational behavior or events acceptable by devising a rational reason.reason.

Undoing:Undoing: actions designed to make amends or cancel out actions designed to make amends or cancel out inappropriate behavior.inappropriate behavior.

Interview TechniquesInterview Techniques

Knowing how to encourage the bestKnowing how to encourage the bestcommunication between communication between YOUYOU and the and thepatient.patient. Closed questionsClosed questions – can be – can be answered with a simple yes/no.answered with a simple yes/no. Open-ended questionsOpen-ended questions – encourage the – encourage the

patient to verbalize more than just yes/no.patient to verbalize more than just yes/no. Indirect StatementsIndirect Statements – elicit a response – elicit a response

from patient without patient feeling from patient without patient feeling questioned. questioned.