Question
What are the key elements of a therapeutic relationship with patients?
Answer
The key elements of a therapeutic relationship include unconditional acceptance, empathy, genuineness, attending and listening, open-ended questions, and silence.
Unconditional Acceptance
Unconditional acceptance should occur regardless of our patient's social standing, ethnicity, background, or presenting illness. We need to treat them the same and use our therapeutic selves to create a relationship with them.
Empathy
We should show empathy. Empathy is not the same as sympathy. Empathy is when we feel with a person, not for a person. Empathy is feeling from the inside outward. It is when we can see with the eyes of another person, listen with their ears, and feel with their heart.
Genuineness
Genuineness cannot really be learned. We need to enter patient rooms and interact with the patients and families with our most clear, genuine, most honest self as we treat them.
Attending and Listening
When you are talking with a patient or their family, especially things like ventilator weaning or trach weaning, it can be scary. It can be very scary for patients when we remove them from their ventilator, cap their trach, or make them walk after they have not walked for three weeks.
One thing to keep in mind when attending and listening is the physical environment. When you are speaking with families and have those special topics to share and want their attention, think about your privacy. Try to minimize interruption so you can get their full attention and they can have yours.
Your posture is important. Anytime you can go into a patient's room and sit down to talk with them it shows them that you are taking extra time with them. Look at them at eye level and lean forward with a relaxed posture and make good eye contact while talking.
Use good listening skills, such as active listening. Show that you are listening, not just putting the breathing treatment in the ventilator or adjusting ventilator settings while they are talking.
Open-Ended Questions
When you are interacting with patients, ask open-ended questions so they can expand on what they would like to share. Try to avoid yes and no questions when you can. One of the strategies of communication is called the reflection strategy. That is when you pick up on the last few words that a patient may say to you and encourage them to talk more about that. You might say, “Could you please expand a little bit more on that point?”
Silence
Silence is important too, as it gives the patient time to think. It also gives the practitioner time to think. Consider that when you are working with patients. Have that moment of silence allowing everyone to get their thoughts in order.
