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Summary of therapeutic communication
Reflection on therapeutic communication
Reflection on therapeutic communication
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Mental illness is a condition that affects the way a person thinks, feels that will eventually change an individual ability to relate well with others (Boyd, 2017). This situation is considered to be a disability that has a long-term effect on patients whose suffering from it. Working with a person who is suffering from mental illness may not be manageable at first because they’re is too much pressure on what they might do wrong which leads to lack of insecurity (Knapp 2014). As a nurse being around a mentally ill patient, one must encourage and support good mental health and well-being of the individual. Anxiety of the unknown can be expected on the first day of clinical’s because I did not know if the patient that they are working with will …show more content…
Transference can either be positive or negative the term includes redirection of feelings and desires towards a project. It is used to refer to beliefs particular romantic feelings to the therapist. This is as a result of being rejected in the past (Knapp 2014). The problem associated with transference is that instead of connecting with a person, their negative feelings and experiences tend to be redirected to another individual, in this case, the therapist. This is a problem because it prevents a therapist from communicating with the patient in a more meaningful and reasonable way (Knapp 2014). Counter-transference is when the therapist or nurse’s reactions to a patient that are based on interpersonal experiences, feelings, and attitudes. It can significantly interfere with the nurse–patient relationship (Boyd, 2017). A good example would be when a nurse is working in a pediatric unit and observes one of her patients behaving or doing similar activities as her son and refers to her patient as her …show more content…
This took place when she asked her client to tell her the main reason as to why she came to the clinic. Also, there is the practical communication with the client whereby as noted, efficient communication between the nurse and her client was evident when the client was able to respond to the nurse's question when she was being asked by the nurse the reason why she was nervous (Knapp 2014). Additionally, there is allow time to communicate with the client. This approach requires that the nurse should allow time to communicate with the client. The nurse has to wait for the client’s response patiently without forcing and pressuring her to talk (Knapp 2014). Also, the patient has to wait for the nurse to make the point so that there is no confusion or
In classical psychoanalysis, transference was seen as a distortion in the therapeutic relationship which occurred when the client unconsciously misperceived the therapist as having personality characteristics similar to someone in his/her past, while countertransference referred to the analyst's unconscious, neurotic reaction to the patient's transference (Freud, 1910/1959). Freud believed that countertransference impedes therapy, and that the analyst must recognize his/her countertransference in order to overcome it. In recent years, some schools of psychotherapy have expanded the definition of countertransference to include all conscious and unconscious feelings or attitudes a therapists has toward a client, holding that countertransference feelings are potentially beneficial to treatment (Singer & Luborsky, 1977). Using more specific language, Corey (1991) defines countertransference as the process of seeing oneself in the client, of overidentifying with the client or of meeting needs through the client.
Countertransference first introduced by Freud, “as a therapist’s unconscious reaction to a patient’s transference” (Dass-Brailsford, pg. 293, 2007). This concept has since become known as a normal emotional reaction to a client. This reaction that comes from the therapist is a resolved or unresolved conflict within the therapist (Dass-Brailsford, 2007). This has nothing to do with the client but something the client said or did triggered the therapist. If this goes unnoticed, it can be detrimental to the client’s recovery. The therapist may begin to overidentify with the client and lose their sense of hope (Dass-Brailsford, 2007).
Transference is when a client unconsciously projects onto their therapists past feelings, desires, expectation or attitudes they had toward their caregivers or significant people in their lives (Corey & et. al, 2011). Transference can originate from early childhood experiences and memories. The client is viewing the therapist in a distorted way. Instead of seeing the therapist as a professional, the clients see the therapist as a parent, or another significant person in their lives. Clients can come off as hostile and anger towards the therapist in a therapeutic session when a client displays negative transference (Corey & et. al, 2011). Transference can help the therapist understand the relationships that clients have had
For example, she dwells on her feelings and thinks that since “nobody else feels this way, I am alone, and I am a disappointment.” The client disregards her feelings by pushing them away because she should not be feeling this way. Furthermore, the client engages in overgeneralization. For example, the client’s negative experiences on her first day as a waitress lead her to believe that the negative event was a result of her not being good enough. The client believes she is recently not good at anything because of one negative event that occurred. The client’s way to cope is by isolating herself and becoming distant. The isolation reinforces her negative symptoms of low mood and feelings of
Many graduate nurses will seek jobs in traditional medical settings. Theses settings can include the emergency department, long-term care, outpatient clinics, medical-surgical inpatient floors and intensive care units. Graduate nurses must remember that they will at some point encounter a patient that is also diagnosed with a mental illness in any of these settings. It is imperative that the nurse feel competent in his or her ability to asses and treat these patients. The gradua...
According to the article, “A Risk to Himself: Attitudes Toward Psychiatric Patients and Choice of Psychosocial Strategies Among Nurses in Medical-Surgical Units”, Nurses professional attitudes towards stereotyped psychiatric patients have a major effect on the psychosocial interventions chosen for that patient.” In the article, stereotype is defined as a cognitive element of a strongly held attitude toward a particular social group (Nelson, 2006). Nurses working in different units outside of the psych unit in the hospital are expected to know how to care for psychiatric patients ( Zolneirek, 2009). These nurses base there nursing implications on past personal experience with dealing with other psychiatric patients (MacNeela, Scott, Treacy, & Hyde, 2010). The article elaborates on a research study done by 13 nurses that watch a video of a psychiatric patient with anxiety that was admitted to a med-surgical unit. Research in Nursing and Health, discovered that “Nurses professional attitudes play a key factor in the psychosocial strategies chosen for psychiatric patients”. The two attitudes chosen amongst the nurses in the research study for the psychiatric patient were risk, vulnerability, or both. Depending on the attitude towards the patient, the nurses recommended three psychosocial interventions: Reassurance, encouragement, and structured engagement.
Understanding the counseling session from the client’s perspective is a very important aspect in the development of a therapeutic relationship. A clinician must be an excellent listener, while being to pay attention to the client’s body language, affect and tone. The dynamics in the counseling session that is beneficial to the client include the recognition of the pain that the client is feeling. The detrimental part of this includes a misunderstanding of the real issues, a lack of consideration of the cultural aspects of the client, and a lack of clinical experience or listening skills. In this presentation, we will discuss the positive and negative aspects of the counseling session from the client’s perspective which includes the client’s attitudes, feelings, and emotions of the counseling session. We will next examine the propensity of the client to reveal or not reveal information to the counselor, and how transference, and counter-transference can have an effect on the counselor-client relationship.
Transference and counter transference is one of most important aspects of treatment between patient and practitioner. In a clinical setting we do not always have the opportunity to have consecutive treatments with the same patient and as a result may not be able to acknowledge or notice these occurrences. It is not often that I have the opportunity to see a patient on a regular basis or even twice for that matter. As a result, it is not possible for me to notice or recognize any transference that the patient my have towards me. At times however, I clearly know the impose counter-transference & boundaries issues which patient and I experience.
Countertransference on the other hand is the response that is elicited in the therapist by the patient’s unconscious transference communications. Very often, it includes both feelings and associated thoughts. According to Gabbard (2004), it is most widely used to refer to the therapist’s cognitive-affective responses to the client (as cited in Cartwright, 2011). Freud conceptualized “countertransference” as arising from the client’s influence on the psychoanalyst’s unconscious feelings, a manifestation of the psychoanalyst’s unresolved issues, and a potential impediment to treatment (Storr, 1989). Countertransference can serve as a sensitive interpersonal barometer, a finely tuned instrument in the field of social interaction. For a therapist who feels irritated by a patient for no clear reason may eventually uncover subtle unconscious provocations by the patient that irritate and repel others, and thereby keep the patient unwittingly lonely and isolated.
t's problems. Instead, it should permit the client to feel that she has support to dive into emotions she might have been afraid to do so before entering client centered therapy. It is interesting to note according to Raskin et al. ( 2011), “Our basic practice [client centered therapy] remains true to the core conditions no matter who our client may be. We also assert that our ability to form an initial therapeutic relationship depends on our own openness to and appreciation of respect for all kinds of difference” (p. 183).
It is essential for a nurse to be able to demonstrate and practice professional communication skills, provision of information and handover to provide a holistic approach to treating and caring for patients. Professional communication skills not only allows the nurse to provide different methods and tactics to communicate with patients of different needs and ages, but it enables the nurse to understand and to give the best possible care and outcome for the patient. Provision of information and handover is another major point for nurses and relates to professional communication. Nurses need to be able to get a detailed diagnosis from the patient through communication, and therefore allows for the nurse to handover vital information to other doctors or nurses who take over to provide the correct and best possible treatments and care. The nursing profession requires a nurse to uphold professional communication, provision of information and handover in order to care for the patient with the right treatment, and to provide the best health outcome.
Furthermore it’s very important not to judge the patient pertaining to what they may have to say. Good communication helps nurses build a relationship with their patient. Linking my personal experience from the clinical area relates to the practical side of nursing. It is necessary for communication between the nurse and the patient to be clear, understandable, appropriate and
My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.
Communication in the nursing practice and in healthcare is important because when talking with patients, their families, and staff, the nurse and the nursing student needs to be able to efficiently express the information that they want the other person to understand. “Verbal communication is a primary way of transmitting vital information concerning patient issues in hospital settings” (Raica, 2009, para. 1). When proper communication skills are lacking in nursing practice, the chances of errors and risks to the patient’s safety increases. One crucial aspect of communication that affects the patient care outcome is how the nurse and the nursing student interacts and communicates with the physicians and other staff members. If the nurse is not clear and concise when relaying patient information to other members of the healthcare team the patient care may be below the expected quality.
...o take control of the conversation, if they desire. Making observations - articulating what is perceived and/or observed (Current Nursing, 2013). Reflecting – directing questions towards the patient based on the topic of discussion, to ensure the patient feels recognized and accepted. Attempting to translate words into feelings – by trying to put into words what the client is trying to express indirectly (Current Nursing, 2013). The nurse must be able to identify non-verbal communication – body language, such as the patients dress, posture, facial expressions etc. Identify the client’s problem - problem solving skills include: having a discussion based on the promotion of positive change, discussing procedures and techniques to cope with situations that are un-changeable, and encouraging the patient to implement the recommended procedures (Current Nursing, 2013).