LESSON PLAN

ON

THERAPEUTIC COMMUNICATION

Mrs. JAYANTHI K,

Associate Professor,

Department of Mental Health Nursing,

ICON.
 Therapeutic Communication

NAME OF THE TEACHER : Mrs. Jayanthi K, Assoc. Prof, Dept. of MHN

COLLEGE : Indirani College of Nursing

COURSE : B.Sc. (N) III YEAR

SUBJECT : Mental Health Nursing

TOPIC : Therapeutic Communication

DATE AND TIME :

METHOD OF TEACHING : Lecture cum Discussion

DURATION : 2 Hours

AV AIDS : Black Board, Roller Board, Chart, Hand Out, PowerPoint.

GENERAL OBJECTIVE:

The students will be able to acquire adequate knowledge about application of therapeutic communication in psychiatric setup and to
develop a desirable attitude and skill in practicing therapeutic communication in psychiatric health care settings.

SPECIFIC OBJECTIVE:

At the end of the class the students will be able to,

 introduce the topic

 state the components of therapeutic communication
 enumerate the phases of therapeutic communication
 Type Of Av
S.No Time Specific Content Aids Used
Teachers Learners Evaluation
Objective Activity Activity
1. 15 mins introduce the topic A relationship is defined as a state of being Black Board Teaching Learning Introduce the topic
related or a state of affinity between two
individuals. The nurse and client interact with
each other in the health care system with the goal
of assisting the client to use personal resources to
meet his or her unique needs.
2. 45 mins state the COMPONENTS OF THERAPEUTIC Handouts Teaching Learning What are the
components of RELATIONSHIP components of
therapeutic 1. Rapport therapeutic
communication Rapport is a relationship or communication?
communicationespecially when useful and
harmonious. It is thecrux of a therapeutic
relationship between the nurse and the patient. It
is:
• a willingness tobecome involved with
anotherperson
• growth towards mutual acceptance and
understanding of individuality
the end result of one's care and concern
foranother.
The nurse establishes rapport through
demonstrationof understanding, warmth and
nonjudgmentalattitude. A skilled nurse will be
ableto establish rapport that will alleviate the
patient'sproblems. When rapport develops, the
patientFeelscomfortablewith the nurse and finds it
easierto self-disclose. The nurse also feels
comfortableand recognizes that an interpersonal
bond oralliance is developing.
2. Empathy
 Empathy is an ability to feel with the patient
while retaining the ability to critically
analyze the situation.
 Satisfying the needs of each otherVaries
may last for years Both are responsible and
accountable Personal/ emotional attachment
and interest involved Relationship may exist
lifelong or terminate gradually.
 It is the ability to put oneself in
 anotherperson's circumstances and feelings.
 The nurse need not necessarily have to
experience it, but has to be able to imagine
the feelings associated with the experience.
 In empathy process the nurse
receivesinformation from the patient with
an open, non judgemental acceptance, and
communicates this understanding of the
experience and feelings so that the patient
feels understood. This serves as a basis for
the relationship.
 Sympathy is often confused with empathy.
In sympathy, the nurse actually feels what
the patient feels but in the process
objectivity is lost, and the nurse becomes
focused on relief of personal distress rather
than on assisting the patient to resolve the
problem. With empathy while
understanding the patient's thoughts and
feelings, the nurse is able to maintain
sufficient objectivity to allow the patient to
 achieve problem resolution with minimal
assistance.
3. Warmth
Warmth is the ability to help the client feel
caredfor and comfortable. It shows acceptance of
theclient as a unique individual. It involves anon-
possessive caring for the client as a personand a
willingness to share the client's joys andsorrows.
4. Genuineness
 Genuineness involves being one's own self.
This implies that the nurse is aware of her
thoughts, feelings, values and their
relevance in the immediate interaction with
a client.
 The nurse's response to the client is sincere
and reflects her internal response. It is also
important that the nurse's verbal and non-
verbal communication correspond with each
other.
3 45 mins enumerate the PHASES OF THERAPEUTIC Pamphlets Teaching Learning What are the phases of
phases of RELATIONSHIP therapeutic
therapeutic Four phases of relationship process have been communication?
communication identified
• Pre-interaction phase
• Introductory or orientation phase
• Working phase
• Termination phase
Pre-interaction Phase
 This phase begins when the nurse is assigned
toinitiate a therapeutic relationship and
includesall that the nurse thinks, feelsor does
immediatelyprior to the first interaction with
the patient. Thenurse's initial task is one of
self-exploration. Thenurse may have
misconceptions and prejudicesabout
psychiatric patients and may have
feelingsand fears common to all novices.
Many nursesexpress feelings of inadequacy
and fear ofhurtingor exploiting the patient.
Another common fear ofnurses is related to
the stereotyped psychiatricpatients' abusive
and violent behavior.
 The nurse should also explore feelings of
 Inferiority,insecurity, approval-seeking
behaviorsetc. This self-analysis is a
necessary task because,to be effective,she
should have a reasonably stableself-concept
and an adequate amount of selfesteem.
Nurse's tasks in the pre-interaction phase
• Explore own feelings, fantasies and fears
• Analyze own professional strengths and
limitations
• Gather data about patient whenever possible
• Plan for first meeting with patient
Introductory or Orientation Phase
During the introductory phase that the nurse and
patient meet for the first time. One of the nurse’s
primary concerns is to find out why thepatient
sought help. This forms the basis of thenursing
assessment and helps the nurse to focus on the
patient's problem and to determine patient's level
of motivation.
Nurse's tasks in the orientation phase
  Establish rapport, trust and acceptance
 Establish communication; assist in the
verbalexpression of thoughts and feelings
Working Phase
 Most of the therapeutic work is carried out
duringthe working phase.
 The nurse and the patientexplore relevant
stressor and promote thedevelopment of
insight in the patient. Bylinkingperceptions,
thoughts, feelings and actions, thenurse
helps the patient to master anxieties,increase
independence and coping mechanisms.
 Actual behavioral change is the focus of
attentionin this phase of the relationship.
Nurse's tasks in the working phase
• Gather further data; explore relevant stressors
• Promote patient's development of insight anduse
of constructive coping mechanisms
• Facilitate behavioral change; encourage himto
evaluate the results of his behavior
• Provide him with opportunities for
independentfunctioning
• Evaluate problems and goals and redefine as
necessary
Termination Phase
This is the most difficult, but most
importantphase of the therapeutic nurse-patient
relationship.
The goal of this phase is to bring atherapeutic end
to the relationship.
Criteria for determining patient's readiness
fortermination:
• Patient experiences relief from
presentingproblems
• Patient's social function has improved
andisolation has decreased
• Patient's ego functions are strengthened andhe
has attained a sense of identity
• Patient employsmore effectiveand
productivedefense mechanisms
• Patient has achieved the planned treatmentgoals
Nurse's tasks in the termination phase:
 • Establish reality of separation
• Mutually explore feelings of rejection,
loss,sadness, anger and related behaviorReview
rogress of therapy and attainment ofgoals
• Formulate plans for meeting future
therapyNeeds

SUMMARY:

Till now I have discussed about the introduction components and phases of therapeutic communication.

CONCLUSION:

I hope that you all understand about therapeutic communication and its components and phases.

Assignment

Write an assignment on Therapeutic Communication Phases

Test

1. Explain Therapeutic Communication Components (5)

2. Elaborate Therapeutic Communication Phases (10)
BIBLIOGRAPHY:

STUDENT REFERANCES:
1. Sreevani, R. A Guide to Mental Health and Psychiatric Nursing. 4th ed. Jaypee Brothers Medical Publishers. New Delhi. 2016
2. K. Lalitha (2007),”Mental health and psychiatric nursing and Indian perspective” 1st edition, Bangalore, VMG book house.

3. Niraj Ahuja, A short textbook of psychiatry, Jaypee brothers, New delhi, 2002.
4. Bimla Kapoor, Textbook of Psychiatric Nursing, Vol. I & II Kumar publishing house Delhi, 2001

TEACHER REFERANCES:
1. Dr. Ellakkuvana, Bhashara (2014),”DEBR’ s Mental health Nursing ”, first edition, Emmess publication.
2. CL Subash Indra Kumar (2014), “textbook of psychiatric and Mental health nursing”, 1st edition, New Delhi, Emmess publication.

3. Stuart (GW), Principles and Practice of Psychiatric Nursing, Elsevier, 8th Edition, 2005

4. Mary C Townsend. “Psychiatric Mental Health Nursing”. Concept of care, 4th edition. F.A.Davis Co. Philadelphia 2003.
5. Sreevani, R. A Guide to Mental Health and Psychiatric Nursing. 4th ed. Jaypee Brothers Medical Publishers. New Delhi. 2016
6. K. Lalitha (2007),”Mental health and psychiatric nursing and Indian perspective” 1st edition, Bangalore, VMG book house.

7. Niraj Ahuja, A short textbook of psychiatry, Jaypee brothers, New delhi, 2002.
8. Bimla Kapoor, Textbook of Psychiatric Nursing, Vol. I & II Kumar publishing house Delhi, 2001