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Administrative medical assisting 5th by lindh chapter05

Chapter 5

Therapeutic Communication Skills

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Importance of Communication
• Therapeutic communication






Introduces element of empathy
Specific and well-defined professional skills
Foundation of all patient care
Nontechnical language
Technically accurate


© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Communication Cycle
• Two or more individuals exchanging
information
• Sending and receiving messages
• Four basic elements





Sender
Message and channel or mode of communication
Receiver
Feedback

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Communication Cycle

The communication cycle and
channels of communication >>

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Communication Cycle
• The sender
– Encoding or creating message to be sent

• The message
– Content being communicated
– Must be understood clearly by receiver


– Four modes of communication





Speaking
Listening
Gestures or body language
Writing

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Communication Cycle
• The receiver
– Recipient of sender’s message
– Must decode (interpret) meaning of message
– Sensory skill in verbal communication is listening

• Feedback
– After receiver has decoded message sent by
sender
– Receiver’s way of ensuring message that is
understood is same as message sent

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Communication Cycle
• Listening skills
– Active listening: received message sent back to
sender, worded a little differently, for verification
from sender
– Listening with a “third ear”

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Communication Cycle
• Listening skills
– Listening goals
• Improve listening skills so patients are heard accurately
• Listen either for what is not being said or for information
transmitted only by hints
• Determine how accurately message has been received

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Verbal communication
– Takes place when message is spoken
– Sender and receiver must apply same meaning to
spoken words

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Verbal communication
– The Five Cs of communication






Complete
Clear
Concise
Cohesive
Courteous

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Verbal communication
– Good communication skills necessary in
establishing rapport with patients
– Patients feel respected and validated when called
by full name
– Patients should be encouraged to verbalize their
feelings and concerns

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Verbal communication
– Patients should be given technical information in
manner that they can understand
– Patients should be allowed to make practical
application to their personal health needs

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Nonverbal
communication
– Body language
• Unconscious body
movements, gestures,
facial expressions

Body language can
communicate more
than spoken words >>

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Nonverbal communication
– Body language





Expressions that accompany speech
Kinesics is study of body language
Body language learned first
Body language influenced by primary caregivers and culture

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Nonverbal communication
– Feelings and emotions communicated through
nonverbal means
• 70% of language is nonverbal
• Tone of voice communicates 23% of message
• Spoken word communicates 7% of message

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Nonverbal communication
– Facial expression
• Eyes reflect feelings
• Staring is invasion of privacy
• Cultural influences affect facial expressions

– Personal space
• Comfortable with others while communicating
• Handled differently by various cultures
• Beneficial to explain procedures that invade another’s space

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Nonverbal communication
– Posture
• Relates to position of body or parts of body
• Involves at least half the body

– Position
• Physical stance of two individuals while communicating
• Face-to-face communication
• Should enable observation of verbal and nonverbal cues

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
Nonverbal
communication

Positive posture and
position encourage
therapeutic
communication >>

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Types of Communication
• Nonverbal communication
– Gestures and mannerisms
• “Talk” with hands
• Enhances spoken word

– Touch





Communicates what cannot be expressed in words
Requires use of good judgment on part of professional
Linked closely to personal space
Not all patients are comfortable with touch

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Congruency in Communication
• Verbal and nonverbal messages must
agree
• Meaning of mixed messages
• Clustering: grouping of nonverbal
messages into statements or
conclusions
• Masking: attempt to conceal or repress
true feeling or message
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Congruency in Communication
• Perception
– Conscious awareness of one’s own feelings and
the feelings of others
– Sense another’s attitudes, moods, feelings
– Follow perceived assessments with verbal
validation
– Easily misinterpreted

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Factors Affecting Therapeutic
Communication
• Barriers






Age
Economic
Education and life experience
Bias and prejudice
Verbal roadblocks

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Factors Affecting Therapeutic
Communication
• Defense mechanisms










Regression
Denial
Repression
Projection
Sublimation
Displacement
Compensation
Rationalization
Undoing
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Factors Affecting Therapeutic
Communication
• Barriers caused by cultural and religious
diversity





Communication context
Caregiving expectations
Time focus
Attitude toward Western medicine

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Factors Affecting Therapeutic
Communication
• Human needs
as barriers to
therapeutic
communication

Maslow’s hierarchy of
needs >>

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


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