Therapeutic Communication Techniques

Technique Examples Description/Rationale

Active listening ✔ Nodding This technique shows patients that the
✔ Maintaining eye contact healthcare provider is genuinely interested
✔ Providing verbal in what they are saying. It helps the patient
acknowledgement like “I feel heard and understood, which can
see” or “Go on” encourage them to share more information.

SOLER Technique
● Squarely face the
speaker: Position your
body to face the person
talking. This shows that
you're engaged and paying
attention
● Open posture: Avoid
crossing your arms or legs.
An open posture signals
that you are receptive and
approachable.
● Lean forward: Leaning in
slightly shows interest and
attentiveness to the
conversation. It signals that
you are actively engaged in
what the speaker is saying.
● Eye contact: Maintain
appropriate eye contact to
show that you're focused
and listening. It helps build
trust and shows that you're
giving the speaker your full
attention.
● Relax: Stay calm and
composed, demonstrating a
relaxed attitude toward the
conversation. Tension or
discomfort can be
distracting for both you and
the speaker.

Open Ended “Can you tell me more about Open-ended questions encourage patients
Questions you’re feeling today?” to express their thoughts and feelings more
fully, providing valuable information that
can guide treatment and care
Reflecting Client: “What do you think I Questions and feelings are referred back to
should do about my wife’s the client so that they may be recognized
drinking problem?” and accepted and so that the client may
Nurse: “What do you think you recognize that his or her point of view has
 should do?” value—a good technique to use when the
client asks the nurse for advice.
Client: “My sister won’t help a bit
with my mother’s care. I have to
do it all!”
Nurse: “You feel angry when she
doesn’t help.
Clarifying “When you say you’re not feeling Clarifying ensures that the provider
well, can you describe what you accurately understands the patient’s
mean by that?” message, preventing misunderstandings
and ensuring effective communication
Paraphrasing If a patient explains a complex Paraphrasing demonstrates that the
situation, the provider right provider is listening and helps to confirm
summarize it, saying, “So, you’re that the provider has understood the
saying that the medication makes patient’s message correctly
you feel dizzy and disoriented?
Summarizing At the end of the conversation, Summarizing reinforces what has been
the provider might say, “Today, discussed, ensuring that both the provider
we discussed your treatment plan and patient are on the same page and
and the next steps for managing understand the key points
your symptoms.”
Silence The client pauses midsentence in Silence gives the client the opportunity to
answering a question. The nurse collect and organize thoughts, to think
remains quiet, does not “rescue” through a point, or to consider introducing a
the client with prompts or by topic of greater concern than the one being
moving on to another question, discussed.
and ensures that his or her body
language and facial expression
project interest in and willingness
to wait for the client to answer.
Providing
Information
Offering Self ✔ “I’ll stay with you awhile.” Making oneself available on an
✔ “We can eat our lunch unconditional basis helps to increase the
together.” client’s feelings of self-worth.
✔ “I’m interested in talking with
you.”

Using Touch A gentle hand on the shoulder or Appropriate touch can provide comfort and
holding a patient’s hand convey compassion. Especially in moments
of distress
Restating Client: “I can’t study. My mind Repeating the main idea of what the client
keeps wandering.” has said lets the client know whether an
Nurse: “You have trouble expressed statement has been understood
concentrating.” and gives him or her the chance to continue
or to clarify if necessary.
Client: “I can’t take that new job.
What if I can’t do it?”
 Nurse: “You’re afraid you will fail
in this new position.

Focusing “This point seems worth looking Taking notice of a single idea or even a
at more closely. Perhaps you and I single word works especially well with a
can discuss it together. client who is moving rapidly from one
thought to another. This technique is not
therapeutic, however, with the client who is
very anxious. Focusing should not be
pursued until the anxiety level has
subsided.
Accepting ✔ “Yes, I understand what you Conveys an attitude of reception and
said.” regard.
✔ Eye contact; nodding

Giving Recognition ✔ “Hello, Mr. J. I notice that you Acknowledging and indicating awareness is
made a ceramic ash tray in better than complimenting, which reflects
OT.” the nurse’s judgment.
✔ “I see you made your bed.”

Giving Broad ✔ “What would you like to talk Allowing the client to take the initiative in
Openings about today?” introducing the topic emphasizes the
✔ “Tell me what you are importance of the client’s role in the
thinking.” interaction.

Offering General ✔ “Yes, I see.” General leads, or prompts, offer the client
Leads ✔ “Go on.” encouragement to continue.
✔ “And after that?”

Placing the Event ✔ “What seemed to lead up to . . Clarifying the relationship of events in time
in Time or . ?” enables the nurse and client to view them in
Sequence ✔ “Was this before or perspective.
after . . . ?”
✔ “When did this happen?”

Making ✔ “You seem tense.” Verbalizing what is observed or perceived

Observations ✔ “I notice you are pacing a lot.” encourages the client to recognize specific
✔ “You seem uncomfortable behaviors and compare perceptions with
when you..” the nurse.
Encouraging Asking the client to verbalize what is being
Description of perceived is often used with clients
Perceptions experiencing hallucinations.
Encouraging ✔ “Was this something Asking the client to compare similarities and
Comparison like . . . ?” differences in ideas, experiences, or
✔ “How does this compare with interpersonal relationships helps the client
the time when . . . ?” recognize life experiences that tend to recur
✔ “What was your response the as well as those aspects of life that are
last time this situation
 occurred?” changeable.

Exploring ✔ “Please explain that situation Delving further into a subject, idea,
in more detail.” experience, or relationship is especially
✔ “Tell me more about that helpful with clients who tend to remain on a
particular situation.” superficial level of communication.
However, if the client chooses not to
disclose further information, the nurse
should refrain from pushing or probing in an
area that obviously creates discomfort.
Seeking ✔ “I’m not sure that I Striving to explain that which is vague or
Clarification and understand. Would you please incomprehensible and searching for mutual
Validation explain?” understanding of what has been said
✔ “Tell me if my understanding facilitates and increases understanding for
agrees with yours.” both client and nurse.
✔ “Do I understand correctly
that you said . . . ?”

Presenting Reality ✔ “I understand that the voices When the client has a misperception of the
seem real to you, but I do not environment, the nurse defines reality or
hear any voices.” indicates his or her perception of the
✔ “There is no one else in the situation for the client
room but you and me.

Voicing Doubt ✔ “I understand that you believe Expressing uncertainty as to the reality of
that to be true, but I see the the client’s perceptions is a technique often
situation differently.” used with clients experiencing delusional
✔ “I find that hard to believe (or thinking.
accept).”
✔ “That seems rather doubtful to
me.”

Verbalizing the Client: “It’s a waste of time to be Putting into words what the client has only
Implied here. I can’t talk to you or implied or said indirectly is a helpful
anyone.” technique to use with clients who are
Nurse: “Are you feeling that no reticent to speak as well as with clients who
one understands?” are mute or are otherwise experiencing
impaired verbal communication. This
Client: (Mute) clarifies that which is implicit rather than
Nurse: “It must have been very explicit.
difficult for you when your
husband died in the fire.”

Attempting to Client: “I’m way out in the ocean.” When feelings are expressed indirectly, the
Translate Nurse: “You must be feeling very nurse tries to “desymbolize” what has been
Words into lonely right now. said and to find clues to the underlying true
Feelings feelings.
Formulating a Plan ✔ “What could you do to let your When a client has a plan in mind for dealing
of Action anger out harmlessly?” with what is considered to be a stressful
✔ “Next time this comes up, situation, it may serve to prevent anger or
what might you do to handle it anxiety from escalating to an
more appropriately?” unmanageable level.

Nontherapeutic Communication Techniques

Technique Examples Description/Rationale

Giving False Telling a patient, “Everything will This can minimize the patient’s concerns
Reassurance be okay,” without any factual and create a sense of mistrust when
basis outcome is uncertain
Giving Advice “If I were you, I would just take Can undermine the patient’s autonomy and
the medication and not worry ability to make their own decisions,
about it.” potentially leading to resentment or
dependency
Defensiveness “I did everything I could, so don’t Can create a barrier to open
blame me if things didn’t go as communication, making patient’s feel
planned.” unheard and invalidated
Stereotyping Assuming that an elderly patient Can lead to biased assumptions and
is hard of hearing and speaking behaviors that do not respect the
louder than necessary individual’s unique characteristics and
needs
Probing Persistently asking, “Why did you Can make patients feel interrogated and
do that?’, or “Why didn’t you judged, leading to discomfort and
follow the doctors order?” reluctance to share information.
Changing the Patient: “I’m really scared about Can dismiss the patient’s concerns, making
Subject my test results.” them feel their issues are unimportant
Nurse: “Did you see the news last
night?”
Using Cliches “Time heals all wounds” Can be dismissive and unhelpful, failing to
acknowledge the patient’s unique
experiences and feelings
Expressing “You shouldn’t feel that way” or Can invalidate the patient’s feelings and
Disapproval “It’s wrong to think like that” inhibit open communication
Interrupting Cutting off the patient while they Can make patients feel disrespected and
are speaking to offer your own unimportant, disrupting the flow of
opinion or solution communication.
Using Medical “Your MRI shows a meningioma in Can confuse and alienate patients,
Jargon the left frontal lobe” preventing them from fully understanding
their condition and treatment
Being Patronizing Speaking to an adult patient in a Can be insulting and diminish the patient’s
childlike or condescending sense of dignity and self worth
manner
Minimizing “It’s not that bad, other patients Can invalidate their emotions and
Feelings have it worse” experiences, making them feel
misunderstood and unsupported.
Using Closed- “Are you feeling better?” instead Can limit the patient’s responses and
Ended Questions of “How are you feeling today?” reduce the opportunity for them to express
their throught and feelings fully.
Rejecting “Let’s not discuss. . . .” Refusing to consider or showing contempt
“I don’t want to hear about. . . .” for the client’s ideas or behavior may cause
Better to say: “Let’s look at that a the client to discontinue interaction with the
little nurse for fear of further rejection
closer.
Agreeing or “That’s right. I agree.” Indicating accord with or opposition to the
Disagreeing “That’s wrong. I disagree.” client’s ideas or opinions implies that the
“I don’t believe that.” nurse has the right to pass judgment on
Better to say: “Let’s discuss what whether the client’s ideas or opinions are
you feel is unfair about the new “right” or “wrong.” Agreement prevents the
community rules.” client from later modifying his or her point
of view without admitting error.
Disagreement implies inaccuracy, provoking
the need for defensiveness on the part of
the client.
Introducing an Client: “I don’t have anything to Changing the subject causes the nurse to
unrelated live for.” take over the direction of the discussion.
topic Nurse: “Did you have visitors this This may occur in order to get to something
weekend?” that the nurse wants to discuss with the
Better technique: The nurse must client or to get away from a topic that he or
remain she prefers not to discuss.
open and free to hear the client
and to
take in all that is being conveyed,
both
verbally and nonverbally.