NURSING 5: Developing Communication Skills for Therapeutic Alliance

This presentation, designed for a NURSING 5 course, explores the critical role of communication skills in establishing a therapeutic alliance between therapists and patients. It emphasizes the importance of active listening and cultural competence as foundational elements. The presentation delves into the components of motivational interviewing, including empathy, developing discrepancy, avoiding argumentation, and supporting self-efficacy, highlighting their impact on fostering patient motivation and engagement. Furthermore, it outlines practical strategies for incorporating these communication skills into clinical practice, such as assessing therapist communication issues through surveys and providing targeted training. The content also includes references to relevant research articles supporting the presented concepts. The presentation aims to equip nursing professionals with the knowledge and tools to enhance their interactions with patients, ultimately improving patient outcomes.

Running Head: NURSING
Nursing
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Slide 1: Communication skills for therapeutic alliance with patients
For a therapist it is highly crucial to develop an effective therapeutic alliance with the client or a
healthcare service user since it imposes high impact on the recovery rate of the same. Two of the
basic communication skills that are highly crucial for a therapist or counsellor to possess include
active listening as well as demonstrating cultural competences.
Now, when it comes to active listening, first thing we need to consider is that demonstrating an
active listening helps the client to express their concerns in an effective as well as open manner.
While a cline tells a therapist his or her story, it is comprised of mixture of experiences, affects,
behaviours as well as experiences (Halkett et al., 2016). The therapist has to listen to the mix of
experiences, behavior and feelings the client uses to describe his or her problem situation. Also
“hear” what the client is not saying. It also helps the therapist to interprets the non verbal
massages of the client. Therapists should learn how to read and respond to non-verbal signals
(posture), expression and expressions, facial (smiles, frowns, lifted eyebrows, bent lips), speech,
and so forth. This includes the physiological reaction (fitness, height, weight, skin, facial
appearance), and the associated action (ton, tone, level of speech, strength, inflective, word
spacings, focus, pauses, silences and smoothing), observable physiological responses (fitness,
transient rash, blushing, paleness) and pupil dilation. Thus active listening can help the therapists
to understand the client so that effective therapy can be given leading to an efferent therapeutic
alliance between client and therapist (Hennrick & Byrd, 2019).
The second factor which is highly crucial for an efficient therapeutic alliance includes cultural
competence. The culture of the client is an integral part of his or her personality and lack of
cultural competence of the therapists can not only impact the therapeutic alliance adversely but

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can even lead to legal issues. Hence, while communicating with the client, it is highly crucial for
the therapist to demonstrate respect for his or her culture also suggest therapy that does not
hinder cultural or religious belief of the client.
Slide 2: Indentifying components of motivational interview
It can be said that the major components of motivational interview possess direct relation with
the degree of therapeutic alliance between the therapist and the healthcare consumer.
The first component of MI is demonstrating empathy. It is the most crucial factor to be
considered by the therapist while conducting a therapy since lack of empathy towards the client
as well as his or her condition may lead to elimination of therapeutic alliance. Hence while
conducting the therapy, along with active listing the therapist must show genuine concern by
asking questions that demonstrate respect for the client, his or her culture as well as concerns
(Syzdek et al., 2016). Also, the therapist must avoid asking distracting questions to the clients
and ensure effective communication while listening to the issues of the client. This
communication can be non verbal like “frequent nodding of head” as well as accepting the
ambivalence as normal.
The second component includes developing discripency. People are more likely to improve if
their conduct is strongly at odds with their own moral beliefs and priorities. A therapist who uses
MI on a client who doesn't care about change will benefit through "increasing conflicts." This
tends to shed a light on the gap in what the person thinks he or she needs and wants to do. A
larger difference can help an person discover his own inspiration to improve (Piatt & Chiasson,
2016). The idea that the company does not offer explanations for improvement, rather the client

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is important. Research indicates that after knowing themselves, people come to learn what they
believe.
Slide 3: Indentifying components of motivational interview
As a therapist, one should avoid direct conflict or armament with the client. Instead, the therapist
needs to demonstrate the skill of influencing the client’s motivation to change. Also while
encountering a resistance, instead of saying terms like “this is wrong”, a MI therapists can use
terms like “can we think this way....”
The 4rth component of MI includes supporting self efficiency. This factor plays a major role in
maintain therapeutic alliance with the client. MI's primary goal is to offer hope and to create
confidence that improvements are possible. In his life, a person still faces hurdles. The self-
efficacy of a client–confidence and trust in the capacity to improve–is a key to inspiring
progress. It is also a good prediction for the outcomes of therapy. They may also encourage
client to increase their own success by making them realize the abilities they already have and
have used to affect improvement in previous circumstances.
Slide 4: Incorporating communication skills in clinical practice
In order to ensure that therapists possess effective communication skills. T is highly crucial to for
the management to assess the communication issues possess by the therapists in an institution.
For this data collection tools like survey and interview can be used. The next step includes
Providing effective training to the therapists to develop effective communication skills and Educating
the therapists about the importance of communication skills while treating healthcare service users
(Paul & Moreno-Perez, 2019). This will help the therapists to understand their loopholes and

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develop effective communication skills that can help them to develop and maintain therapeutic
alliance with the client.

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Reference list
Halkett, G., O'Connor, M., Aranda, S., Jefford, M., Merchant, S., York, D., ... & Schofield, P.
(2016). Communication skills training for radiation therapists: preparing patients for
radiation therapy. Journal of medical radiation sciences, 63(4), 232-241.
Hennrick, H. C., & Byrd, M. (2019). Survivor–therapists and sexual-assailant–clients: A unified
approach to sexual communication skills building and assault prevention. Journal of
Psychotherapy Integration, 29(2), 138.
Paul, L., & Moreno-Perez, A. (2019). Beta Testing Can-Do-Tude: An Online Intervention Using
the Principles of Motivational Interviewing for Adolescents with Type 1 Diabetes. On-
Line Journal of Nursing Informatics, 23(1).
Piatt, J. A., & Chiasson, L. (2016). Impact of Motivational Interviewing on Readiness for
Change and Self-care Behaviours of an Assisted Living Resident with Type I Diabetes.
Therapeutic Recreation Journal, 50(3), 228.
Syzdek, M. R., Green, J. D., Lindgren, B. R., & Addis, M. E. (2016). Pilot trial of gender-based
motivational interviewing for increasing mental health service use in college men.
Psychotherapy, 53(1), 124.