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What is Therapeutic Relationship - Establishment, Importance and Uses

5049 Downloads1 I Published: 07 Mar ,2019

Verbal and nonverbal communication in establishing and maintaining a therapeutic relationship

The entire psychiatric nursing system is focussed in the essence of therapeutic relationship between the service provider and service user and despite the variety of approaches, the aim remains the same. In order to enter into relationship both the parties need to have a very good understanding of each other in terms of safety, confidentiality, reliability, consistency and personal boundaries. According to Roberts et al. (2015, p.30), the fact that several ailments which are due to biochemical agents or genetic factors cannot be healed which is quite disheartening. nonetheless, the therapeutic relation can be effective to provide necessary to support the service user to tackle the related emotional issues.

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Task 1

1. What is therapeutic relationship - Importance, development phase, uses

The developing phase of a relationship is very critical to the effectiveness of the services and establishing an alliance can sometimes take a considerable amount of time. The amount of time required to gain the confidence of the service user depends upon the level of skills and years of experience of the service provider. The bonding is necessary so as to reduce the levels of frustration which can lead mutually withdrawing behaviour among both the parties. The therapeutic relations aim to facilitate, assist, help and promote self-care to the service users. The service providers need to be able to facilitate communication pertaining to distressful emotions or thought and assist them with the same (Windover et al. 2014). They are also required to help the clients in order be self-sustained and keeping the destructive behaviours in check thus promoting a self-care behaviour in the service users.

The first interaction between the service provider and service user partially determines the nature of the relation. This means communication is an important component of developing a therapeutic relationship (Gardner et al. 2014). The service provider needs to have effective verbal as well as non-verbal communicative skills in order to introduce themselves to the service users which is necessary for the service users to open up a little to the service provider and subtle gestures such as handshakes can be very effective non-verbal skill which can be used by the service provider in order to establish a sense of trust and honour.

2. Role of values and beliefs in therapeutic relationship

In words of Simmons-Mackie (2013), once the initial relationship has been established the service provider needs to understand the boundaries that they need to maintain in order to adhere to the ethical and professional norms. Service users have their own requirements for privacy and safety and this is required to be recognised and understood by the service provider in order to further strengthen the relationship. In order to provide total customer satisfaction, the service provider needs to keep tab of the basic needs of the service user and this include pills for pain relief or any other prescribed pills for discomfort. It is a legal violation of service user’s rights if their privacy and safety is threatened by the service provider.

During the developing phase, the service user can have a number of concerns which need to be addressed in order to clarify the situation. In order to do this, it is necessary for the service provider to actively listen to the service users and their verbalised account can be restated in order to signify that their concerns have been taken into consideration. However, according to Epstein et al. (2014), if the concerns are restated too much the service users feel that they their concerns are not valued anymore and this can only mean that the service provider is not interested to provide any assistance in order to resolve the issues.

Eye contact is a very important part of the communication, however, there is a fine line between being reassuring and intimidating. The non-verbal gestures are necessary in order to exhibit that the conversations are welcomed and smiling and nodding head can help in boosting the confidence of the service user towards the actions of the service provider (Bloomer et al. 2017). The workers are required to maintain a legible speech tempo and should be able to enunciate properly in order to aid the user’s understanding of the discussions. The way workers speak and listen to the users need to show that their primary objective is to care for the patient.

It has been stated before also that professional boundaries need to be maintained in order to sustain the therapeutic relationship and hence, the workers require to obey the wishes if the customers. Service users may have their perception of how the service should be provided and while some of the patients require therapeutic touches such as hugging some prefer that they are not touched (Webster, 2014). Another very important factor that needs to be taken into account while developing and sustaining the relation is to respect the differences in culture and there is no chance that ill comments regarding the user’s culture will be tolerated.

3. How Therapeutic Relation can be helpful in Communication

Communication is very necessary in order to help the patient achieve harmony in terms of mind and body while being actively engaged in therapeutic relation. The effective communications can help in improving the behaviour of the workers and helps them to incorporate a caring behaviour while conducting the health care and social care services to the service users. The positive result of employing such a relationship can be helpful to both the parties as the service users can enjoy quality services while the service providers can learn from these experiences which can a scale of their competency and capability (Crotty and Doody, 2015).

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While verbal communications are necessary for communicating information, there may be situations when verbal communication may not be possible and in such a situation the use of non-verbal communications skills is necessary to understand the situation. Non-verbal communication showcase an individual's ability to relate and engage in discussions which they use to establish some meaningful interactions that can be used in the everyday activities (Procter et al. 2015). Nonverbal communications or body language need to be positive in order to understand the various unidentified variables in play in therapeutic relations.

References

  • 1. Bloomer, M.J., Endacott, R., Ranse, K. and Coombs, M.A., (2017). Navigating communication with families during withdrawal of life‐sustaining treatment in intensive care: a qualitative descriptive study in Australia and New Zealand. Journal of clinical nursing, 26(5-6), pp.690-697.
  • 2. Crotty, G. and Doody, O., (2015). Therapeutic relationships in intellectual disability nursing practice: Gerard Crotty and Owen Doody describe the nurse-client relationship through its essential building blocks of engagement, empathy, communication and trust. Learning Disability Practice, 18(7), pp.25-29.
  • 3. Epstein, N.B., Curtis, D.S., Edwards, E., Young, J.L. and Zheng, L., (2014). Therapy with families in China: Cultural factors influencing the therapeutic alliance and therapy goals. Contemporary Family Therapy, 36(2), pp.201-212.
  • 4. Gardner, S., Loya, T. and Hyman, C., (2014). FamilyLive: Parental skill building for caregivers with interpersonal trauma exposures. Clinical Social Work Journal, 42(1), pp.81-89.
  • 5. Procter, N., Backhouse, J., Cother, I., Ferguson, M., Fielder, A., Jackson, A., Murison, J. and Reilly, J.A., (2015). Engaging consumers in the Australian emergency mental health context: a qualitative perspective from clinicians working in the community. Health & social care in the community, 23(4), pp.428-436.
  • 6. Roberts, J., Fenton, G. and Barnard, M., (2015). Developing effective therapeutic relationships with children, young people and their families. Nursing children and young people, 27(4), pp.30-35.
  • 7. Simmons-Mackie, N., (2013). Social Role Negotiation in Aphasia Therapy: Competence. Constructing (in) competence: Disabling evaluations in clinical and social interaction, p.313.
  • 8. Webster, D., (2014). Using standardized patients to teach therapeutic communication in psychiatric nursing. Clinical Simulation in Nursing, 10(2), pp.e81-e86.
  • 9. Windover, A.K., Boissy, A., Rice, T.W., Gilligan, T., Velez, V.J. and Merlino, J., (2014). The REDE model of healthcare communication: optimizing relationship as a therapeutic agent. Journal of Patient Experience, 1(1), pp.8-13.
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