Therapeutic Communication: Patient Experience, Models, and Reflection

This report critically reviews therapeutic communication techniques, focusing on a specific patient experience involving a woman named Mary undergoing a breast biopsy. The introduction defines therapeutic communication and its role in enhancing patient well-being. The report describes a scenario where the practitioner utilized the silence technique to address Mary's anxieties. It then critically discusses two helping approaches: the silence approach and open-ended questions, evaluating their effectiveness in this context. The silence approach is further examined, highlighting its suitability in the given situation and its benefits in allowing patients to express their concerns. The report concludes with a critical reflection on the lessons learned from the silence approach, emphasizing its positive impact on facilitating a comfortable and communicative environment, ultimately aiding in a smoother surgical process. The report also explores the use of open-ended questions to encourage patients to share their thoughts and feelings without judgment. The report emphasizes that effective therapeutic communication is critical for building trust and improving patient outcomes.

Therapeutic Communication

TABLE OF CONTENTS
1. Introduction of the topic of critical review.........................................................................1
2. Identification and description of an experience of a therapeutic relationship with a person/
patient.....................................................................................................................................1
3. Critical discussion of two Helping Approaches/Models....................................................2
4. Considering Silence approach and its suitable use in the present situation.......................3
5. Critical reflection on the lessons learned from the chosen helping hand approach which is
the silence approach...............................................................................................................4
6. Conclusion to summarise the key aspect of critical review...............................................5
REFERENCES................................................................................................................................7

1. Introduction of the topic of critical review
Therapeutic communication is considered as a face to face sort of interaction whose
actual forte is to maximize the emotional along with the physical wellbeing of a person (Arnold
and Boggs, 2015). Also, it is classified as the type which helps in providing some sort of help
and support to the patients. Although there are various ways that can be involved in order to
make use of therapeutic communication, a few of them can be involved in case of providing help
to Mary, who is suffering from breast cancer. The report is about ways of therapeutic
communication that are to be involved to provide proper support and care to Mary. Also,
choosing the relevant one out of all is also included.
2. Identification and description of an experience of a therapeutic relationship with a person/
patient
Case Scenario
Therapeutic relationship between patient and practitioner is considered as a helping
relationship that is completely based on the mutual understanding of both as by various means,
the practitioner can try to adopt that conversation with the patient that can help in a better and
efficient conversation. It is important as well because a well conversation between the patient
and practitioner can make the process less complex (Zavertnik, Huff and Munro, 2010). Mary
was suffering from breast cancer, so she went to an outpatient centre for surgery with her
husband. She was very nervous as it was her first time to go under knives. Her nervousness was
visible enough from her body language as she was staring at the ground continuously, tapping
her feet. I was able enough to show her nervousness. It was visible enough that a number of
thoughts were running in her mind. So, I used the silence technique in order to interpret her
feelings and her inside thoughts into words. It is important as well because a well interaction can
help in running the process more smoothly. So, I sat silently behind her and waited her to
express herself to me. After sometime, she told me that many thoughts are running in her mind
as she is scared whether she will be okay or not, whether she would be able to feed her baby
again or not. While this conversation, I explained that everything will be as it was before. There
is nothing to worry. After a few days of the surgery, everything will be normal. Then, she felt a
bit relaxed and I started the procedure for surgery. During the conversation, I had a normal talk
with her also about her daily routine, what she likes, what she does not. I asked her about her
daily routine what she does after waking up etc. Also, I shared some of my own experiences also
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with her. It was a very friendly conversation and I got to know much about her life style. She
shared with me what she likes to do and what she does not like etc. It was a very basic
conversation but was enough to have a sort of interaction with her. It was just to make her more
comfortable and relaxed. The silence technique out of all the therapeutic communication
techniques have been selected in this case because it is obvious that in such an atmosphere, the
patient may feel nervous and anxious, so they should be given some time so that they can be able
to relax themselves and get to a comfortable zone (Webster, 2013). So, I sat on next to her and
waited until she will feel comfortable to speak to me and express her ideas and issues regarding
the surgery. It worked and after some time, she discussed what was she going through. I just
wanted to make her comfortable because she was very nervous about the breast biopsy.
Although, I cleared all her doubts and made her relaxed enough that after the surgery as well, she
must be having just normal life.
3. Critical discussion of two Helping Approaches/Models
Although there are various approaches that can be used in order to provide a therapeutic
communication with Mary such as using the silence technique, using the technique of open
ended questions etc. Both of these are discussed as following:
Using silence approach
It is considered as one of the therapeutic communication techniques that I can make use
of so that Mary can be able to freely discuss her opinion and the issues that are undergoing in her
mind. The basic forte of this technique is to provide a sort of relief and support to Mary, that is
why, I sat silently, gave her enough time for herself. It was visible from her body language and
expressions of face that she was undergoing a hard time, thus she was thinking much about it. It
is obvious that when someone goes under such situations, more negative thoughts start appear on
the mind rather than the positive ones (Rosenberg and Gallo-Silver, 2011). So, I was able to
understand that she must be undergoing something like this, but instead of interrupting her, I
gave her enough time to think and get some relaxed. After a while, she asked me about some of
her doubts she was having in her mind. She asked if after the breast surgery, she would be able to
feed her small baby. I cleared her this doubt by saying yes. I told her that after some days of the
surgery, she will be able to live her daily routine, so there is nothing to worry about. Also, she
asked that whether the area will prone to be more sensitive than before etc. She was full of
thoughts, so it was a good technique to make use of the silence communication that before I gave
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her some time for herself, so that she can continue thinking about the doubts. Till then, I sat and
waited patiently. After some time, she asked me about all these doubts and I made them clear
one by one. Thus, it can be considered as one of the efficient techniques that can be used in order
to interpret the feelings and emotions of the patient into words. Also, it is very important as well
because when there is a better and efficient conversation between patient and doctor, the process
further seems to be more effective and interactive because when things are clear between both
parties, continuing the surgery process for me was easier as she was a bit relaxed after clearing
her doubts.
Using the approach of open ended questions
Using the way of asking open ended questions from Mary can also help. It is also
considered as a way of expressing thoughts and inner feelings (Bar-Sela, Lulav-Grinwald and
Mitnik, 2012). So, I can involve this way also in order to have a therapeutic communication with
Mary. So, in this, I can ask a range of questions to Mary and it may be regarding her basic or
social life. So, if I involve this, I can ask different questions to Mary just because she can be
quite comfortable with me and express what is in her mind. The basic reason behind these open-
ended questions is to get a broader response from the patient. So, I am following the same so that
Mary can also provide the same. It is also considered as an efficient communication because this
supports no sort of judgement, so there cannot be considered any such case that Mary will tell me
something and I will judge her on the basis of that.
It is completely free from a system like that. The forte of such questions is just only that
Mary can make the situation clear in front of me and also, she can speak truly without any doubt
what is going on in her mind. Like I can ask her what type of relationship she has with her
family? what is your own opinion regarding this? what doubts you have in your mind regarding
the breast biopsy? what can I do to relax you? Etc. So, by this way, she can answer these
questions one by one and it will help me in getting the thoughts that are going on her mind. By
this way, I can be able to give her a sort of relaxation so that she can feel relaxed and
comfortable enough. Also, after her doubts regarding the breast biopsy will be cleared, it will
help in the surgery process also as she will be able to cooperate more then.
4. Considering Silence approach and its suitable use in the present situation
The basic forte of therapeutic approaches is to provide a sort of support and help to the
patient so that they can seem comfortable enough during the whole process of surgeries or
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operations (Wachtel, 2011). The reason I included therapeutic communication approaches was
just to make sure that Mary can have a well stay in the centre and also, she can share every doubt
and issue that she was having in her mind. Although there are enormous techniques that come
under therapeutic communication ways but I chose the silence one over all. Other techniques
include reflecting, providing leads, summarizing etc. that are also helpful enough in providing
efficient amount of support to the patient but overall, I prefer the silence technique. The
implementation of this was simple. In this, I just had to sit and wait until Mary may feel
comfortable enough. The process of silence is quite similar to the listening process which is
considered as a purposeful procedure. It is because the receiver in this case gets an efficient
amount of time to think some thoughts of them in their own way. This approach has been
selected because I found it appropriate of all because the nervousness of Mary was visible on her
face, so she must be wanting some own time of her own.
So, I sat behind her and let her think whatever she was thinking so that she can get relaxed.
Silence is considered as that therapeutic way of communication that can be implied in order to
provide the patient ample time with the fact that after some time, the patient can feel comfortable
enough to share their own feelings and expressions. It is just the conversion of inner feelings and
expressions into words and that are enough for making the surgery process easier. It is because
when there has been an efficient conversation between the doctor and the patient, it makes the
patient more relaxed and comfortable. That is the reason, I involved this technique as when Mary
arrived with her husband, she was very nervous and it was visible from his face and body
language only because she was continuously staring at the wall and also was shaking her feet.
So, I thought and decided that the only way to make her comfortable is to give her some time as
she can feel comfortable enough. So, I sat behind her silently and did not disturb her for a while.
After a few hours, she discussed all her issues with me for which she was worried regarding the
breast biopsy. Then, I had an efficient conversation with her and cleared all her doubts regarding
the surgery.
5. Critical reflection on the lessons learned from the chosen helping hand approach which is the
silence approach
Although the silence approach proved very helpful as by this way, I was able to give the
time Mary want. When she got some relaxed and easy, she shared all the doubts with me and I
made all of them clear enough. If in the future, some similar case arises in front of me, rather
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than using silence approach, I will prefer to the acknowledging technique. It is because this is
considered as a way of having concern with the person in a non-judgemental way (Colloca and
Finniss, 2012). So, by involving this, I can ask Mary that when she was sitting outside with her
husband, then I noticed that she was staring at the wall continuously and was tapping her feet.
So, I can ask her about it that was she nervous or some thoughts were running in her mind. I
asked from which thing she is scared of. I made her realise that during such situations such as
surgeries and operations, getting nervous is a very basic thing. So, I made her clear all her doubts
regarding the breast biopsy and understood her that after a few days of the surgery, everything
will become normal. Also, during or after the surgery, if I feel any change in her behaviour etc.,
then also I can have a talk with her and discuss on the same. So, the acknowledgement can be
considered as verbal, nonverbal, writing etc. There is no special form of doing it. Thus, I am free
to speak, act or write whatever my concern is about Mary and also, I will make sure to make her
comfortable enough that she will discuss all the issues and thoughts that are going in her mind.
This form also gives a sort of thought to Mary that I am interested in her and I will help her
no matter what. A very special feature of this is that when I will ask such questions to Mary and
show all the concern I have, in that case, Mary will also feel that I am open and frank enough, so
she can share anything with me. It will make the process much simpler because when there will
be an efficient set of conversation between me and her, I will be able to tell her about the surgery
procedure more briefly and by this way, she will also cooperate completely. So, making an
efficient conversation is very important as it eases the whole process because when a clear
conversation has been done between Mary and me, I will ensure that I will tell briefly about the
procedure of surgery so that she can stay relaxed enough. So, if such case arises in future as well,
I will most probably go for the acknowledgement one after the silence technique because it is
also considered as one of the best and the efficient ones that can actually help me in providing
support to Mary so that she can stay comfortable there without any issue. Also, it will help in
clearing all her doubts as well about the surgery process as she was suffering from breast cancer.
6. Conclusion to summarise the key aspect of critical review
It can be concluded from the report that Mary was suffering from breast cancer, due to
which she visited an outpatient surgery centre. There, she came with her husband and was much
nervous about her surgery. Her nervousness was visible enough on her face and body language.
Two approaches, silence approach and the method of open ended questions have been analysed,
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out of which silence approach has been chosen and being used in the research. So, I make use of
the silence approach just to make her comfortable so that she can stay relaxed before the surgery.
After she told me the thoughts she was going through, I cleared all her doubts. Then, she was
relaxed enough about the whole procedure of the surgery. Also, if in case, I had to face the same
scenario, there is a possibility that I might go for the acknowledgement one because it is also
considered as one of the effective methods for providing help and support to the patients.
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REFERENCES
Books and Journals
Arnold, E. C. and Boggs, K. U., 2015. Interpersonal Relationships-E-Book: Professional
Communication Skills for Nurses. Elsevier Health Sciences.
Bar-Sela, G., Lulav-Grinwald, D. and Mitnik, I., 2012. “Balint group” meetings for oncology
residents as a tool to improve therapeutic communication skills and reduce burnout
level. Journal of Cancer Education. 27(4). pp.786-789.
Colloca, L. and Finniss, D., 2012. Nocebo effects, patient-clinician communication, and
therapeutic outcomes. Jama. 307(6). pp.567-568.
Rosenberg, S. and Gallo-Silver, L., 2011. Therapeutic communication skills and student nurses
in the clinical setting. Teaching and learning in Nursing. 6(1). pp.2-8.
Wachtel, P. L., 2011. Therapeutic communication: Knowing what to say when. Guilford Press.
Webster, D., 2013. Promoting therapeutic communication and patient-centered care using
standardized patients. Journal of Nursing Education. 52(11). pp.645-648.
Zavertnik, J. E., Huff, T. A. and Munro, C. L., 2010. Innovative approach to teaching
communication skills to nursing students. Journal of Nursing Education. 49(2). pp.65-71.
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