Nursing Assignment: Building Therapeutic Relationships with Patients

This nursing assignment delves into the crucial role of therapeutic, compassionate, and effective relationships in healthcare, particularly when working with individuals with learning disabilities. The report emphasizes the importance of communication and understanding the unique challenges faced by these patients. It explores psychosocial theories, specifically Erik Erikson's stages of psychosocial development, as a framework for building therapeutic alliances. The assignment further examines communication models, with a focus on Peplau's Interpersonal Relations Theory, to enhance nurse-patient interactions. The study highlights how effective communication, rooted in these theories, can improve patient comfort, reduce anxiety, and foster a sense of respect and value, ultimately contributing to better health outcomes. The report concludes by underscoring the significance of these relationships for successful patient care and management.

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NURSING ASSIGNMENT
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Introduction
Developing an operative, compassionate and therapeutic association with the patient
is reflected as the most vital or significant aspect of treatment as the patient can express their
issue and concern to the included healthcare provider and lead to beneficial engagement of
the patient and the healthcare providers (Roberts, Fenton & Barnard, 2015). The patients with
learning disabilities cannot interpret of understand the spoken language that is used by the
healthcare providers to communicate with them therefore, it is very essential for the
healthcare providers to develop an effective and therapeutic relationship with the patient and
identify different strategies to communicate with them. This study will emphasize on the
different psycho-social theories, which will be effective in mounting a therapeutic association
with the patient and in turn helping the nurse or the healthcare providers to improve the
health result of the patient (Razzaque & Wood, 2016). This study will also focus on the
model of communication that is majorly used by the healthcare provider to enhance their
relationship with the patient majorly suffering from the learning disabilities.
Description of therapeutic, compassionate and effective relationships when working
with people with learning disabilities
Learning disability is defined as the neurological disorders that results due to the
difference in an individuals’ brain and their incapability to interprets or process any
information. The nurse’s face major difficulties while handling the patient with learning
disabilities because the patient cannot easily understand what the nurse is trying and say and
sometimes misinterpret their directions. Hence, it is very crucial for the nurse to develop a
healthy, effective, compassionate and therapeutic relationship with the patient, which will
help them to treat the patient efficiently (Small et al., 2018). The learning and physical
disabilities have a negative influence on the psychosocial development of the patient and is

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negatively correlated with the interpersonal relationship, self-esteem and adolescent
delinquency. Hence, the nurses or healthcare providers must adapt a psycho-social theory to
overcome from this issue and enhance the interpersonal association with the patient that will
assist them in managing the patient with ease and create a comfortable and healthy
environment for the patient where they can share their concern with the health care provider
(Cooper & Frearson, 2017). The most commonly applied and practiced psycho-social
theories by the nurses to handle the patients suffering from learning disability and creating an
effective therapeutic relationship is Erik Erickson interpersonal theory.
Erikson's stages of psychosocial development
Erik Erikson was the famous stage philosopher who considered the psychosexual
theory of Freud’s and had modified his theory into eight significant stages of psychosocial
developmental theory. According to Erik Erikson, ego plays a crucial role in generating a
positive effect in development by comprising skilled idea and attitude towards each specific
stages of development. This theory had covered the complete lifespan of an individual right
from their infancy to their late adulthood and each individual stage has an emergency that
must be set to develop an effective relationship with the patient suffering from learning
disabilities (Jordan & Tseris, 2018).
The principal stage of the Erikson model of human development states the concept of
trust versus mistrust, which will address the infantile experience of an individual. In case of
an individual suffering from learning disability, the initial recovery stage, trust versus
mistrust takes place during the beginning of their disability condition and they accept their
condition and determine the recovery process that will help them in treating their health
condition (Syed & McLean, 2017). The subsequent stage, autonomy versus shame/doubt, is
considered as the second recovery step where the individual suffering from the learning

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disability encompasses grappling associated with loss of self-control on their mind and also
accepting their personal recovery for better cognitive understanding. This will motivate them
to embrace their disability with a meaningful acceptance (Kropf & Greene, 2017).
The third stage of psycho-social development includes empowerment versus guilt, the
individual who is recovering from their learning disability develop the coping skills and a
positive approach towards their recovery with empowerment that will help them to minimize
their disability and the residual symptoms (Greene, 2017). The fourth stage includes action
versus inaction, which is very much similar with the rehabilitation versus disability for the
individuals suffering from learning disability. In his stage, the individual develops the
concept of “social niche” and it is incorporated in their recovery process. The fifth recovery
stage included in the Erikson model of human development is identity versus role confusion,
where the individual starts recognizing their disability and tries to detach their individuality
from the emotions and consequences of their disability (Forber & Zape, 2017). In this stage,
language becomes the principal concern of discussion.
The sixth stage of psycho-social theory namely intimacy versus violation, states that
the individual with learning disability do not involve their feelings regarding socialization
among the society and therefore face challenges in building an intimate and therapeutic
relationship with the healthcare provider (Branje & Koper, 2018). The seventh stage of
Erikson human development comprise of purpose versus passivity, which includes the
identification of appropriate life strategy that will help the patient to live efficiently with
learning disability and the patient will also develop an appropriate coping skills that will
motivate them to overcome from their disability and achieve the target goal. The final stage
included in the Erikson developmental stage is integrity versus despair that includes the high
level of acceptance among the patient regarding the changes in their life due to disability.
Therefore it is evident that adapting the Erikson's stages of psychosocial development will

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help the healthcare provider to develop an effective and therapeutic relationship with the
patient and motivate them to recover from their health condition (Kail & Cavanaugh, 2016).
Role of communication to promote the development of therapeutic, compassionate and
effective relationships
Building an effective and good relationship with the patient is very crucial for treating
the patient who are suffering from learning disability. In order to handle the patient with
learning disability, it is very important that the healthcare provider effectively communicate
with the patient generating a friendly environment that will help the patient to open up to
them and also participate in their recovery process (Conroy et al., 2017). Good
communication will help the healthcare provider in three different ways such as good
communication will assist the patient to feel comfortable and at ease, it will also help the
patient to take an effective control over their feeling of anxiety or nervousness and lastly it
will help the patient to feel respected and valued. Therefore, it is evident that in order to
handle the patient with learning disability and control their anxiety the nurses or the
healthcare providers will adapt the strategy of developing good communication with them
and help them to feel comfortable. There are different models of communication that will
help the healthcare to develop an effective and therapeutic relationship with the patient (Feo
et al., 2017).
Peplau’s Interpersonal Relations Theory
This is the most widely used and practiced theory (model of communication) for
mounting a therapeutic and interpersonal association with the patient that will allow the
professional to educate the patient and include them in their recovery process. This theory
highlights and explain the different stages of interpersonal development process and their
character in mounting a healthy therapeutic association with the patient. There are four

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different stages that is included in the Peplau’s Interpersonal Relations Theory namely
orientation phase, identification phase, exploitation phase and resolution phase (Jones,
Fitzpatrick & Rogers, 2016). In the orientation phase, the nurse and the client meet each other
and the nurse identify the well-being issue of the patient and the primary step of
communication initiates in this phase. Identification phase is the crucial stage of the theory
where the nurse will explain and educate the patient regarding the health issues and what can
be done to solve the issue. The third stage include in the theory is exploitation phase, where
the nurses focuses in improving the behaviour of the patient and motivate them to adapt the
necessary changes that is required for overcoming the learning disability. The last stage of the
theory is termination theory, where the patient develop the behaviour of self-managing their
issues with appropriate skills and development. During this stage the nurses are mostly
successful in building an effective, compassionate and therapeutic relationship with the
patient (Arnold, 2019).
Conclusion
From this study it can be concluded that developing a therapeutic, effective and
compassionate relationship with the patient is very significant for treating and handling the
patient with learning disability. An effective therapeutic relationship will allow the nurses to
generate a friendly environment, where the patient can easily communicate with the
professionals. This study had exhibited the psycho-social theories and their advantages in
developing a therapeutic relationship such as Erikson's stages of psychosocial development,
which comprise of eight different stages of human development. The role of communication
is also explained by highlighting the model of communication namely Peplau’s Interpersonal
Relations Theory, which focuses on enhancing the communication among the patient and the
healthcare professionals.

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References
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