Two student nurses are preparing for psychiatric-mental health clinical learning experiences.  They decided to review the assigned reading and lecture notes from their class on therapeutic communication.

Case Study, Mohr

CHAPTER 11, Therapeutic Relationships and Communication

In completing the case study, students will be addressing the following learning objectives:

List the key ingredients of therapeutic relationships. Contrast effective and ineffective communication techniques with clients.

1. Two student nurses are preparing for psychiatric-mental health clinical learning experiences.  They decided to review the assigned reading and lecture notes from their class on therapeutic communication. After discussion, the students decided that the elements of respect, genuineness, and caring in talking to clients could lead to a trusting relationship. Both students voiced concern over their ability to develop and maintain a professional and not a social relationship.

(Learning Objectives: 1, 6)

a. How can the student nurses convey the essential elements of a therapeutic relationship in talking to clients?

b. How can the student nurses maintain a professional relationship and avoid a social one for clients in psychiatric settings?

ANSWER

“Building and Maintaining Professional Therapeutic Relationships in Psychiatric Settings: Essential Elements and Guidelines for Student Nurses”

The student nurses can convey the essential elements of a therapeutic relationship in talking to clients by focusing on three key ingredients: respect, genuineness, and caring.

Respect

The student nurses should treat clients with dignity and acknowledge their autonomy. They should actively listen to their concerns, opinions, and feelings without judgment. Respect also involves recognizing and valuing the client’s individuality, cultural background, and personal preferences.

Genuineness

 The student nurses should strive to be authentic and sincere in their interactions with clients. They should convey their true thoughts and feelings while maintaining appropriate professional boundaries. Genuineness allows clients to trust that the nurses’ intentions are honest and transparent.

Caring

The student nurses should demonstrate empathy and compassion towards clients. They should show a genuine interest in the client’s well-being and provide emotional support (Molina-Mula & Gallo-Estrada, 2020b). Caring involves actively engaging in the client’s care and demonstrating a commitment to helping them achieve their goals.

To convey these essential elements, the student nurses can:

Use active listening: Paying attention to verbal and non-verbal cues, maintaining eye contact, and summarizing or reflecting back what the client has said. This shows that the nurses are actively engaged and interested in understanding the client’s perspective.

Validate feelings: Acknowledge the client’s emotions and experiences, even if they differ from the nurses’ own. Validating feelings helps build trust and fosters open communication.

Provide clear and concise information: Using simple and understandable language, the student nurses should communicate information about the client’s condition, treatment plan, and progress. This helps the client feel informed and involved in their care.

Establish rapport: Building rapport involves creating a comfortable and non-threatening environment (Butt, 2021). The student nurses can use appropriate humor, warmth, and empathy to establish a connection with the client.

To maintain a professional relationship and avoid a social one with clients in psychiatric settings, the student nurses should adhere to certain guidelines:

Boundaries: The student nurses need to establish clear boundaries and maintain a professional demeanor at all times. They should avoid sharing personal information or engaging in personal relationships with clients outside the therapeutic context.

Confidentiality: Respecting client confidentiality is crucial. The student nurses should adhere to legal and ethical guidelines regarding the privacy of client information. They should only discuss client-related information in appropriate settings, such as during team meetings or with the client’s informed consent.

Objectivity: The student nurses should maintain objectivity and avoid forming personal judgments about clients (Papathanasiou et al., 2014). They should base their assessments and interventions on factual information and professional standards rather than personal biases.

Professional communication: The student nurses should use clear, concise, and professional language when communicating with clients. They should avoid using jargon or technical terms that the client may not understand. Additionally, they should actively listen to the client’s concerns and respond in a non-confrontational and non-threatening manner.

By following these guidelines, the student nurses can ensure that their interactions with clients remain focused on therapeutic goals and avoid crossing into social relationships. A professional therapeutic relationship is essential for effective communication and positive client outcomes in psychiatric settings.

References

Butt, M. J. (2021). Approaches to building rapport with patients. Clinical Medicine, 21(6), e662–e663. https://doi.org/10.7861/clinmed.2021-0264 

Molina-Mula, J., & Gallo-Estrada, J. (2020b). Impact of Nurse-Patient Relationship on Quality of Care and Patient Autonomy in Decision-Making. International Journal of Environmental Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835 

Papathanasiou, I. V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K., & Kourkouta, L. (2014). Critical Thinking: The Development of an Essential Skill for Nursing Students. Acta Informatica Medica : AIM : Journal of the Society for Medical Informatics of Bosnia & Herzegovina : ČAsopis DrušTva Za Medicinsku Informatiku BiH, 22(4), 283. https://doi.org/10.5455/aim.2014.22.283-286