Therapeutic Communication: A Reflective Essay on Skills and Models

This essay critically examines therapeutic communication within health and social care, focusing on the author's experience in the NHS working with elderly patients. It employs Gibb’s reflective cycle to analyze personal experiences, highlighting the importance of skills such as active listening, observation, and information sharing. The essay critically analyzes the RESPECT and Egan models of communication, detailing how these models can enhance therapeutic relationships through empathy, cultural competence, and problem-solving approaches. The author reflects on the challenges of communication barriers, including cultural differences and patient limitations, and emphasizes the application of the Egan model to empower patients and improve overall care. Desklib offers a wealth of similar solved assignments and study tools for students.

Therapeutic Communication
Assignment 2

TABLE OF CONTENTS
ASSIGNMENT 2.............................................................................................................................3
1. Personal experience of a therapeutic relationship....................................................................3
2. Critically analyzing at least two helping skills or models that could potentially be used.......5
3. Selection of one of helping skills or approach and describing in detail .................................7
4. Reflective statement ................................................................................................................8
REFERENCES..............................................................................................................................10

ASSIGNMENT 2
In context of health and social care, developing effective therapeutic relationship with
patient is one of the major requirements for improvement in physical and mental health.
Communication is the major factor which may influence the association between nurse and
patient (Plumb, 2015). Here, in the present critical essay, main emphasis is given on therapeutic
communication. It will help in understanding the fundamental components of this relationship
and the way of achieving this type of association. I will critically evaluate my own experience in
terms of maintaining therapeutic relationship with elder patients when I was working in NHS. It
is one of the leading health and social care organizations that provide high quality services to
patients as per their needs and requirements. I will use appropriate models and approaches for
getting more facts about therapeutic communication and relationship.
1. Personal experience of a therapeutic relationship
Gibb’s reflective cycle is one of the important models for analyzing personal experience
or activity. Major stages of this cycle are description, feelings, evaluation and analysis as well as
conclusion and action plan. As per the analysis of situation by using Gibbs model, I can describe
the situation in an effective manner. I was working as a health and social care worker in NHS.
My major role was handling elderly patients who were unable to complete their daily life
activities (Shapiro, 2015). These types of patients cannot hear, speak and see properly. Some
patients them have the problem in moving from one place to another. Along with this, there were
some patients who were on bed rest since for last few months.The need of therapeutic
communication involves here when the patients require treatment which has mentioned above
that is all the old age patients who can't hear, speak and see properly which are major senses of
an individual. The personnel of an enterprise are required to give proper information on their
t5reatment in order to aware them what treatment applied by doctor their body to avoid further
complications such as any reactions or allergic to some medicines. The doctor also responsible
for asking about any allergy before prescribing medicines. It is required by a doctor to ask
regrading diabetic, sugar and thyroid problem as any medicine contain glucose will affect the
patient's life. So, at the time of providing health and social care services, we were assured about
giving all services as per their needs and requirements. Sometimes, I realized that all these health
issues create problem in making effective relations with elderly patients. Most of the nurses were
using their strong communication skills for maintaining healthy relations but most of the time,
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they were facing problem in determining the major issues which were being faced by elderly
patients. It has a negative impact on providing health care services to patients. Sometimes,
inappropriate services can create a situation of death of elderly patients. So, I realized that
maintaining therapeutic communication and association is very important for augment the level
of service quality.
At the time of working as a nurse or health and social care worker, I used different skills
for making communication effectual with elderly patients (Wessel, 2016). Major skills applied
by me are active listening, sharing observation and silence, providing information, focusing and
asking relevant questions, etc. at the time of providing services to elder patients. I generally used
to being attentive towards what they want to say. I noticed verbal and non-verbal information
also. Apart from that, I made eye contact with patients that helped me in developing strong
bonding with them. Along with this, sharing observation is also one of the important skills of
communication which has helped in starting conversation about a specific topic. I used to share
my observation with elder patients in terms of their health issues and improvement. For example,
“You look better as compared to yesterday”. It increases attraction of patients towards
discussion. Along with this, I allowed my patients to break their silence as it helped me in
observing all their problems by bringing out their personal feelings and emotions to resolve all
its difficulties by developing accurate solutions.
At the time of giving health and social care services, I provided information about the
health condition to patients (Xin and Li, 2013). Along with this, I also communicated necessary
information about signs and symptoms of diseases which were faced by them. This skill helped
me in getting involved with the patients by which they become comfortable with me at the time
of discussing about their problems and issues. It has helped me in making appropriate decision
about medical treatment. Along with this, I generally asked relevant questions for seeking
information needed for effective decision making. But at the time of questioning, I assured about
to ask one question at a single time. I used open ended questions by which I get opportunity to
make two way communications with patients. It helped me in improving interaction with
patients. Therefore, I used all these skills for making communication effectual with patients.
Being a health and social care worker, I am required to handle number of elderly patients
in a single day. Service users of this age group require health and social care services for twenty-
four hours (Sucala, Schnur and Constantino, 2012). Sometimes, I faced problem in
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understanding their needs because some patients were unable to speak or listen so, it was one of
the major issues at the time of developing therapeutic communication with patients. Along with
this, sometimes, patients were not capable enough to provide information to nurses. In this case,
I faced problem in making appropriate decisions. Including this, cultural differences, changes in
value, beliefs and other aspects also create problem in providing services to patients. So, all these
were the major issues which have their negative impact on therapeutic relationship with patients.
2. Critically analyzing at least two helping skills or models that could potentially be used
There are two different models which could be used by health and social care workers to
make therapeutic communication. RESPECT and Egan models of communication have
introduced number of skills for making strong association with clients or patients.
Respect model:
When I was working with NHS, I could apply Respect Model at the time of making
communication with elder people. Self-assessment has reflected that there was a huge difference
between culture of patients and health and social care workers. Anderson and et.al., (2015) have
asserted that “cultural differences as well as ethnic and religious beliefs influence the definition
of health, well being and causes of illness”. Elderly patients of NHS come from number of
backgrounds, so, providing appropriate respect to their culture helps in understanding their needs
and requirements and reasons behind illness. I could use respect model for getting knowledge
about their culture and making communication with patients. Riley, (2015) has stated that
“respect model includes different skills such as Rapport, Empathy, Support, Partnership,
Explanations, Cultural Competence and Trust”. According to this model and rapport skill, I
could pay attention towards the patient’s point of view because hasty assumptions and judgment
leads to wrong decisions. So, I could focus on customers and their opinions before making
decisions about their treatment. Empathy is another attribute of the respect model and according
to this, I could use empathy as a skill for maintaining relations with elder patients. Apart from
that, I could focus on rational of patients and acknowledge their feelings before making any
judgment for their medical issues or problems. But, on the other hand, support is also one
requirement which plays an important role in making healthy relations with elder patients. At the
time of working, I could try to understand major barriers which can create issues at the time of
providing medical services to patients. Along with this, I could involve family members also for
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getting support in determining the needs and requirements of every patient (Plumb, 2015). Along
with this, partnership working is also another skill which is introduced by respect model for
making therapeutic communication with patients. As per this skill, I could focus on working
together with patients to address physical therapy concern. In addition to this, I could provide
appropriate explanation to elder patients about the reasons behind their illness as well as I could
check and ensure about that whether they understood my explanation or not. On the other hand, I
could have appropriate competencies to understand different cultures and provide respect to
patient’s beliefs and values. However, as per the respect model, self-disclose is very difficult for
some patients so, I could provide appropriate time to establish trust. Therefore, all these skills
could be applied by me at the time of providing health and social care services to elderly patients
of NHS.
Egan model
Skilled helper model is one of the appropriate tools which have introduced some specific
skills that can be used by health and social workers for developing therapeutic relationship with
their patients. Priebe, Burns and Craig, (2013) have concluded that “this model focuses on two
basic approaches, that is, person and problem centered. The people centered approach is focusing
on improving an individual as person by enhancing their self-empowerment and a kind o0f belief
to navigate itself in complex difficulties. This belief is fostered by encouraging them to consider
all possibilities for resolution and renewed normalcy. This approach is also recognized as silent
guide method in which all the clients that is the patients are guided to lift up all their problems in
front of the care takers in order to help them to devise appropriate plan for their overall
improvement. Another approach of this model is problem centered whose lays main emphasis on
all the problems faced by an individual to resolve all their difficulties by propounding different
and unique solutions to all the problems (Moss, 2015). Using this approach the counselors fix the
primary problems by developing conclusions to gather all different problems under one roof by
propounding unanimous problems. The basic problem faced by all; the patients is that their
immense pain as they are suffering from terminal diseases. As per the basic human tendency, the
persons usually don't like share their pain with someone else as they hesitate more which piles up
their pain and transform into resistance to take treatment to heal all their pains. The piling up of
all the pains, hostility and aggression creates virtually isolated world where the patients don't
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want anybody's interference. The primary objective of this technique is to bring out all their
pains and aggression to stop them to enter that virtual world.
As per the study of Bang and Thum, (2012) says that this model encourages clients to
become active I interpreters of the world in terms of actions, events and situations, facing and
overcoming challenges, exploring issues, seeking new opportunities and establishing goals. It is
generally related to developing personality of an individuals and resolving all their problems by
creating new problem-solving strategies. Its basic aim is to help all, its patients to develop its
skills and the knowledge which is essential to solve both their existing problems and prospective
aspects that may arise in near future. It facilitates a client in development as it targets individuals
and reducing all its problems which created loyalty among their patients. As a human nature one
who helps another person, they are like a god for them and they obey that person. Old age
peoples are treated like a child and its counselors are acting as their parent to maintain their
health in delicate way.
3. Selection of one of helping skills or approach and describing in detail
The Egan model helps patients to overcome their problem as when it comes to treatment their
mentality gets changed as they feel negative aspects in terms of their treatment. This models
helps patients to understand the benefited of treatment provided by the hospitals for their
betterment. Counselors are the real heroes who personally interact with the patients by changing
their negative perspectives into positive one. It also helps to remove social isolation feeling of an
individual. It helps in bridges gap between management and the patients by identifying the real
situations of both of them.
From the point of view of Shapiro, (2015) Egan model has been selected from two
models described above in defining appropriate relationship between a counselor and its patients
by focusing on therapeutic relationship. Counselors are that person who cares about its patients
more than its family members as they give all kind of services in medical terms and non-medical
terms such as affection, love, care as a parent. In old age, the family members are not caring all
its parents and other grand members of their family in order to make their career or all other
reasons and left their elder one in care homes. The isolation and a feeling of loneliness is another
problems faced by an individual. The role therapeutic has increases when the wider audiences
have increased and their immense pain has increases with the passage of time.
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This model has three stages which helps in further defining its nature in order describes
its role play in therapeutic communication takes place between a counselor and patients.
Exploring stage involves exploration of client's situations by correlation with the counseling
skills applied by an individual in order understand its depth. The baa sic purpose of this stage is
to build a non threatening counseling according to the preferences of the patients to give them all
its benefits (Fan and Taylor, 2016). It helps to identifying the problems by clarifying all the
issues by filtration net which brings ample of opportunities and access different kinds of
resources. Apart from getting benefits and different opportunities it also involves several
challenge comes in the path of a counselor such as excuses, evasiveness, distortions and negative
self-statements. Different techniques and activities applied here include open questioning,
paraphrasing and summarizing. There are various benefits involve in identifying clients problems
is that its helps in maintaining proper relationship among client and counselor, clear
understanding among, helps in proper devising of improvement plans and procedures.
Another stage of this model involves understanding skills which helps in facilitate a
client in developing a more in-depth and understanding of the objective of their own situations.
This stage enact as skill assistance for a patient in explko0ring opinions and possible
goals. It establishes according to the taste of a patient to benefit them so that the treatment will
not be imposed either they should take it as a compliment rather than imposing any kind of
punishment (Arnold and Boggs, 2015). Different techniques shall be applied at this stage
consists of brainstorming, divergent thinking, balance sheet approach and field analysis. Its
benefits are interaction among all the patients and all other employees which creates friendly
environment. It also results in breaking up of the thinking shells of all the patients to give them
unique surroundings to completely forget about all its pains and involved in great joy and
pleasure. It helps in breaking all the isolated worlds of the patients and giving them new reasons
to live by forget about all their pasts. By using group activities, games and interaction sessions
the perfect treatment has been given to reduce all the stress level. Happiness is that medicine
which reduces all the pains and aggression of a person in fewer periods. Another factor is that a
time is a healing factor which fades away all the past and unwanted memories that will only ruin
a person's life and remembering them is not fruitful for an individual.
Last stage of this model is acting skills which are an appropriate action to define all the
goals, changing behaviors, working with issues, decision making skills, providing support and
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encouragement (Annoni and Miller, 2016). It helps a client to cope with current trouble which
forms one of the bases for changing learning attitude that will enable a patient to live more
effectively in the future. This stage is dependent on above two stages that is exploration and
understanding of skills and capabilities required by an individual. This stage is implementation
stage where necessary strategies have been executed at its proper place after adequate research
on a given problem. This execution plays a significant role as all its research's outcomes are
depended on its proper implementation. Basically it is a summarized form of two stages
described above to give a clear idea regarding its actual benefits it provides to all the patients to
relieve all, their pains (Entwistle and Watt, 2013).
4. Reflective statement
After conducting critical analysis, I have learnt lots of new skills and knowledge which
has improved my understanding about the importance of therapeutic relationship. Along with
this, now, I realized that communication skills play an important role in making healthy relations
between patients and nurses by which social workers can provide better services to improve their
physical and mental health. Egan skilled helper model is the most appropriate technique for
improving relationship with clients.
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REFERENCES
Books and Journals
Anderson, G. M. and et.al, 2015. Autism as a disorder of biological and behavioral rhythms:
toward new therapeutic perspectives. New treatment perspectives in autism spectrum
disorders, p.56.
Annoni, M. and Miller, F. G., 2016. Placebo Effects and the Ethics of Therapeutic
Communication: A Pragmatic Perspective. Kennedy Institute of Ethics Journal. 26(1). pp.
79-103.
Arnold, E. C. and Boggs, K. U., 2015. Interpersonal relationships: Professional communication
skills for nurses. Elsevier Health Sciences.
Bang, C. and Thum, T., 2012. Exosomes: New players in cell–cell communication. The
international journal of biochemistry & cell biology.44(11). pp.2060-2064.
Birks, M., Chapman, Y. B. and Davis, J., 2015. Professional and Therapeutic Communication.
Oxford University Press.
Fan, C. W. and Taylor, R. R., 2016. Assessing Therapeutic Communication during
Rehabilitation: The Clinical Assessment of Modes. American Journal of Occupational
Therapy. 70(4). Pp.7004280010p1-7004280010p10.
Moss, B., 2015. Communication skills in health and social care. Sage.
Plumb, J., 2015. Therapeutic communication with people experiencing mental
illness. Communicating Quality and Safety in Health Care. p.136.
Priebe, S., Burns, T. and Craig, T.K., 2013. The future of academic psychiatry may be
social. The British Journal of Psychiatry. 202(5). pp.319-320.
Riley, J. B., 2015. Communication in nursing. Elsevier Health Sciences.
Shapiro, Y., 2015. Channels of therapeutic communication. Psychoanalytic Dialogues. 25.
pp.124-130.
Sucala, M., Schnur, J. B., Constantino, M. J., 2012. The therapeutic relationship in e-therapy for
mental health: a systematic review. Journal of Medical Internet Research. 14(4). p.e110.
Wessel, P., 2016. Two-way television enabled therapeutic communication systems and methods.
U.S. Patent 20,160,073,165.
Xin, H., Li, Y., 2013. Systemic administration of exosomes released from mesenchymal stromal
cells promote functional recovery and neurovascular plasticity after stroke in rats. Journal
of Cerebral Blood Flow & Metabolism. 33(11). pp.1711-1715.
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Online
Entwistle, A. V. and Watt, S. I., 2013. Treating Patients as Persons: A Capabilities Approach to
Support Delivery of Person-Centered Care. [Online]. Available through:
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746461/ >. [Accessed on 20th September
2016].
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