Therapeutic Communication: Mary's Case Study, Models and Frameworks

This report examines a case study of Mary, a 48-year-old patient dealing with obesity, asthma, and hypertension, with a focus on therapeutic communication. The report details the different types of stress Mary may experience and how to build a therapeutic relationship with her, including active listening, maintaining professional boundaries, and respecting cultural differences. Two helping skills approaches are discussed: the Social Cognitive Approach, which focuses on changing Mary's behavior regarding hormone therapy, and the Stages of Change Model, also known as the Trans-theoretical Model, to assess Mary's readiness for behavioral change. The report includes the advantages and disadvantages of each model, providing a comprehensive analysis of how these frameworks can be applied to improve patient outcomes and facilitate effective communication in a healthcare setting. The report aims to equip healthcare professionals with the necessary tools to address patient concerns and provide appropriate treatment plans.

Therapeutic
Communication

INTRODUCTION
This project is about therapeutic communication that refers to a practice including face-
to-face procedure of interaction by focussing on physical and emotional wellness of the patient.
It includes to make a healthy conversation with patient to make them comfortable and provide
information them about relevant issue or treatment process to be done for their well-being (Orsu
and Koyyada, 2020). In context of this assignment, it is based on the case study of Mary with age
of 48 years suffering from obese condition and being treated for asthma & hypertension. This
report will focus on different types of stress of patient and models helping for the situation. It
will also include description of appropriate frameworks to be used in given situation. The critical
reflection of lessons learned from using selected approach is given below.
MAIN BODY
Describe the case scenario that is above. Consider the different types of stresses/worries that
Mary might facing. Explain how you would build a therapeutic relationship with her.
According to the given case study, a patient with age of 48 named Mary who married
with George and is mother of three teenager children. She was employed as a teacher in primary
school and she has an obese condition and remain under treatment of asthma as well as the
problem of hypertension. However, the patient not prefer to carry out physical exercise on
regular basis as she is a symptomatic of hip bursitis. It has been analysed that the existence of
hip bursitis is not due to any kind of intake medication or physiotherapy. Patient was diagnosed
with the symptoms of perimenopause with frequent hot flushes since last 6 months. It is observed
that care profession offer the treatment of hormone therapy which is refused by patient because
of her internal feeling of uncertainty as her mother diet from breast cancer before 2 years. Mary
faced stress or worries in relation to her situation which are explained here.
Stress can be described as a feeling when an individual is struggling for overcome with
challenges like financial crisis, work, relationships, health problems, environment and other
situations (Zhang and et. al., 2019). It includes the different factors behind stressed condition of a
person which is required to be cope up with otherwise it will create psychological problems. In
context of Mary, she is suffering from number of health problems which are responsible for
stress developing condition of tress for her.

Acute stress: This refers to most often occurred stress type among people which can be
consider as an immediate reaction to new event, challenge or demand. It is responsible for
triggering fight to flight response which occurs due to near miss auto mobile accident, an
argument with family or costly mistake at work sink in. However, it has be analysed that acute
stress is not necessarily negative all the time because it enhance ability of a person to avoid
problematic incidents in future (Moein, 2017). In context of Mary, this stress occur when she
know about her condition of hip bursitis for a while which facilitate her to consult with physician
to get treatment of the same.
Episodic acute stress: In this context, it includes the condition when acute stress take
place in frequent manner in gap of few hours or days which is known as episodic acute stress.
Basically, this condition occurs for people who always seems to be having crisis and facing
problem continuously from a long duration of time. A person with episodic acute stress are
observed to be short tempered often, feel irritate quickly and remain anxious. However, it has
been evaluated that this kind of stress impact negatively health of an individual. It is difficult of
suffered people to overcome with their lifestyle or change it because they have already accepted
that stress as a part of their life. In respect of given case, Mary may indicate such symptoms due
to having stress because of existing health problem like asthma, hypertension, obesity and hip
bursitis.
Chronic stress: The unsolved acute stress is responsible for enhancing the situation
among period of time which results into chronic stress. It includes chronic stress condition which
remain constant in life of a person and does not go away. However, this condition mostly occurs
due to several factors such as a dysfunctional family, an unhappy marriage, a bad job and
poverty (Cheng and Huang, 2019). In case of Mary, she was refused to undergo through
hormone therapy for treating the problem of hip bursitis then it is required to clear her doubts. It
is necessary to make patient understand about different reason behind her mother and importance
of hormone therapy for well-being of patient.
Considering the given case study, it has been evaluated that hormone therapy is much
effective for Mary in order to treat her problem of hip bursitis but her refusing create a challenge
for care professionals to conduct the process. It consist the conduct an effective communication
with patient in order to make them understand about benefits of selected clinical process.
However, it is very important to convince individual about treatment and deliver it as soon as

possible because delayed in services can create complications. Steps to establish therapeutic
relationship with Mary are given here.
Initially, it is required to give introduction by care professional and use patient name while
talking with them along with initiate meeting by hand shaking. Professional should show respect
towards the individual for gaining their trust quickly (Jell and et. al., 2019). Secondly, it is
necessary to ensure about maintenance of patient privacy while providing care and met basic
needs like reliving pain or other discomforts. Thirdly, the care practitioner should listen patient
in active manner for ensuring about understanding of concerns of Mary. It includes to clear
patient doubts about hormone therapy by explaining relevant benefits. However, it is essential to
maintain eye contact which create trust and make sure that eye contact of profession should not
be too much intimidating. It is required to smile at intervals to involve patient along with voice
inflection that they care about individual. Moreover, it is important to maintaining professional
boundaries because few of individuals desires more therapeutic touch like hugging, hand-holding
while some of them do not prefer touching which should be avoided. It is very essential to
respect differences between various cultures and follow limitations while communicating with
patient respectively.
Critically discuss at least two helping skills approaches/models/frameworks that you could
potentially use in that situation.
The health models plays an important role to understand specific medical situation of
patient in order to provide appropriate treatment of their well-being. It includes the way of
analysing various cases of patient with different health problem including relevant complications
to deal with the in proper manner (Hjort and Pedersen, 2016). However, the care professionals
gain support through these frameworks to make correct decision about treatment for making a
person disease free. There are various kinds of health models in which few of them are suitable
in case of Mary that are given here.
Social cognitive approach: The social cognitive model is used for given patient to
deliver effective care for improving their recovery which facilitate to make them disease free.
This framework can be defined as an impact on environment factors, impact of own experience
and actions of others in health behaviour of an individual. It is helpful to render chance regarding
social help via self efficacy, utilising observational learning, instilling expectations and factors
for facilitating behavioural change of a patient. In context of given case, it is required to change

behaviour of Mary as she refuses to take hormone therapy which is essential for her wellness. It
is required to improved her doubts about treatment and make convinced to gain desired care
services to become disease free. Social cognitive theory has its number of components which are
required to be focused by medical practitioners associated with case of Mary that are explained
further.
Self efficacy – This involves to believe about an individual that they has a control over
themselves and they are much capable to execute a behaviour.
Behavioural capability – It includes the ability to understand about specific situation and
contain skill for performing a behaviour (Gomis and et. al., 2018).
Expectations – This consist the expected outcomes related behaviour after implementing
the desired change.
Expectancies – The step of assign the values to specific outputs in regards to change in
behaviour accordingly.
Self control – This can be defined as to carry out regulation and monitor the behaviour of
an individual to avoid misconduct of anything.
Observational learning – It includes to gain an effective learning by proper observation
and watching the outcomes of other people performing or modelling the desired behaviour.
Reinforcements – It consists to attempt regarding promotional incentives a well rewards
which encourage behaviour change of employees for improving their performance.
The above factors are important part of social cognitive approach which should be
considered by physician while treating the condition of selected patient. It will provide support to
improve the condition of patient and make them disease free as soon as possible. However, these
components are important to be sued for gaining better outcomes of social cognitive framework.
Advantages consist that it can be consider as an accumulated an impressive research record.
This theory is concerned with important social behaviour of people (Wang and et. al., 2019).
It is known as an evolving theory which is open to change that is favourable to deal with
different situations. It is responsible to concentrate in essential theoretical problems including
stability of behaviour to overcome with the same. It consist the reasonable opinion of
individuals along with concerning with social implications of the theory.
Disadvantages includes that it is not completely systematised, loosely organised and known
to be a unified framework. It has controversial issues like reinforcement is essential for both

performance as well as learning. It has few of neglected aspects such as maturation &
changes of lifespan ignored and reduced attention regarding conflict, emotion & motivation.
The findings of this theory are consider as preliminary.
Stages of change model (trans-theoretical model): This model is also known as trans
theoretical model which is helpful to evaluate about readiness of a person in regards to change
their behaviour. It is essential to change behaviour of Mary so that she will ready to gain
hormonal therapy. However, the change model is suitable for give case study by consider its key
stages which are explained here.
Pre-contemplation – In this stage, individual do not aware about the fact that their
existing behaviour is problematic for them or may develop severe consequences.
Contemplation – This includes when a person realise that their behaviour is not
appropriate and tend to improve the same.
Preparation – In context of this stage, people become ready to focus on their problematic
behaviour in order to change the same within a specific duration of time (Vecchio and et. al.,
2018).
Action – It consist to take action and gain recent change in their behaviours in a short
period of time.
Maintenance – The changed behaviour is required to be maintain by encouraging people
to continue the same for a long duration of time.
Termination – There is no desire or returning to previous negative behaviours of an
individual.
Advantages and disadvantages of Stages of change model
Advantages consist that it is helpful in recognising the temporal nature of change to take
effective measures for desired behavioural change among people. It is favourable in
determining groups remaining more open for certain interventions which is suitable in
different circumstances. This framework is much capable in terms of addressing the
behaviours.
Disadvantages includes that it is trans theoretical but construct from frameworks which are
not well integrated into a model. It has a demerit that relations among variables was not well-
established. It consist that predictive power is limited. The tailored interventions crucial but
is a time consuming as well as expensive process.

Select one of these helping skills approaches/models/frameworks and describe in detail why you
find it the most appropriate to use in the situation.
In context of given case, the professional associated with case of Mary should focus on
social cognitive theory which is more suitable for the same. It is favourable to consider various
key elements of this framework which is helpful to change the behaviour of an individual.
However, this model is helpful if followed in corrects sequence by considering steps like self
efficacy, behavioural capability, expectations, expectancies, self control, observational learning
and reinforcements. In addition to this, it has been analysed that social cognitive theory is much
capable to change behaviour of Mary as she refuses to gain hormone therapy. Moreover, this
theory is more appropriate to convince patient for appropriate treatment procedure.
On the other hand, it is very important to make patient convinced very soon otherwise
they may acquire extreme complicated condition. It is favourable to encourage patient by
explaining the about related benefits for their health along with make them inform about relevant
complexities if not treated on time (Finocchiaro and et. al., 2019). It is suitable to gain
permission of Mary to carry out process of hormone therapy which is essential regarding her
condition of facing perimenopause and hip bursitis respectively. The care professionals to use
social cognitive model which is favourable to improve her health condition in effective as well as
efficient manner. The patient also has problem which are being treated like asthma and
hypertension so that other disease should be treat on time in order to maintain entire health
situation.
Critically reflect on the lessons that can be learnt from using such an approach in that context.
Considering the case of Mary, I have learned many aspects about establishing therapeutic
relationship with patient along with analysing its benefits. It is very important for care
professional to gain trust of an individual through removing their fear and discomfort. However,
it is necessary to build mutual understanding with patient which impact positively on convincing
process as well as clinical outcomes. It has been evaluated that patient has fear of some clinical
process of treatment due to wrong assumption which is required to be clarified by medical
practitioners which helps to conduct desired treatment procedure in proper manner.
I believe that comfort level of patient is very important to gain their complete cooperation
during the clinical activities. It is also analysed that professional boundaries are mandatory to be
maintained while talking with patient because few of individual desires touch though hand shake

or hugging. A care professional should remain completely professional and communicate
politely with patient which is helpful to establish mutual understanding for treating health issuer
effectively. It is favourable in context of Mary to make her understanding about necessity of
hormone therapy for her well-being.
CONCLUSION
From the above assignment, it has been summarised that therapeutic communication can
be described as face-to-face procedure of interaction by focussing on physical and emotional
wellness of an individual. It includes the types of stress like acute, episodic acute and chronic
stress in terms of given patient. However, the health models can be used to deal with selected
situation like social cognitive theory by considering self efficacy, behavioural capability,
expectations, expectancies, self control, observational learning and reinforcements. Moreover, it
also consist use of trans-theoretical model by following pre-contemplation, contemplation,
preparation, action maintenance and termination.

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