Therapeutic communication keeps the focus on the client's feelings and needs. On exams, the right answer usually invites the client to keep talking.
Techniques that work
| Technique | Example |
|---|---|
| Open-ended questions | "How have you been feeling since the diagnosis?" |
| Reflecting | Client: "I can't do this anymore." Nurse: "You feel like you can't go on?" |
| Restating | "You said you haven't slept in three days." |
| Clarifying | "I'm not sure I follow. Can you tell me more?" |
| Silence | Sitting quietly and giving the client time to think |
| Offering self | "I'll sit with you for a while." |
| Presenting reality | "I don't hear any voices, but I understand they seem real to you." |
| Focusing | "Let's talk more about your worry about going home." |
Responses to avoid
| Avoid | Example | Why |
|---|---|---|
| False reassurance | "Everything will be fine." | Dismisses real fears |
| "Why" questions | "Why did you do that?" | Feels judging and makes people defensive |
| Giving advice | "If I were you, I would…" | Takes away the client's choice |
| Changing the subject | "Let's talk about something happier." | Shuts the client down |
| Approving or disapproving | "That's good." / "You shouldn't feel that way." | Judges feelings |
| Defending | "Your doctor is the best in the hospital." | Ignores the client's concern |
Exam strategy
- Safety first. If the client is in danger, act. Communication can wait.
- Pick the answer that focuses on the client's feelings, not the nurse's.
- Eliminate answers with false reassurance, "why," advice, or a change of subject.
A client says, "I'm scared about my surgery tomorrow." What is the best response?
- "Don't worry. Your surgeon is excellent."
- "Tell me more about what scares you."
- "Why are you scared? It's a simple surgery."
- "Let's watch TV to take your mind off it."
Show answer
B. It is open-ended and focuses on the client's feelings. The others give false reassurance, ask "why," or change the subject.
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Quick answers
What is an example of therapeutic communication?
Open-ended questions like "How are you feeling about that?", reflecting feelings back, restating, clarifying, and using silence.
Why should nurses avoid asking "why" questions?
"Why" questions can feel judging and make the client defensive, which shuts down communication.
Evidence & Clinical Sources
- Halter, Varcarolis' Foundations of Psychiatric-Mental Health Nursing, Elsevier
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