| A | B |
|---|
| Agreeing or Disagreeing | Indicating consensus with or opposition to the client's ideas or opinions. "That's right. I think so too." "That's wrong. I disagree." "I don't believe that." Better to verbalize: "Let's discuss what you feel is unfair about the new community rules |
| Silence | Gives the client the opportunity to consider what is being said, weigh alternatives, and formulate an answer. |
| Belittling | Discounting clients’ feelings or perceptions When the nurse misjudges the degree of the client's discomfort, a lack of empathy & understanding may be conveyed. Client: "I have nothing to live for. I wish I were dead." Nurse: "Everybody gets down in the dumps at times. I feel that way myself sometimes." Better to verbalize: "You must be very upset. Tell me what you are feeling right now." |
| Broad Openings | Communicates a desire to begin a meaningful interaction and allows the client to take the initiative in introducing the topic; emphasizes the importance of the client's role in the interaction. "What would you like to talk about today?" "Tell me what you are thinking?" “Where would you like to begin?” |
| Challenging | Denying clients perceptions; inviting or daring a client to explain, act, or compete, to prove unrealistic ideas and/or perceptions, with the intention of the patient realizing that he/she has no "proof" and will be forced to acknowledge what is "true." |
| Clarification & Validation | Dissipates possible misunderstandings by striving to explain that which is vague or incomprehensible. Searching for mutual understanding; illuminating the meaning of what has been said. Facilitates & increases understanding for both client & nurse. "I'm not sure that I understand. Would you please explain?" "Tell me if my understanding agrees with yours." "Do I understand correctly that you said...?" |
| Defending | Attempting to protect someone or something from verbal attack. "No one here would lie to you." "You have a very capable physician. I'm sure he only has your best interest in mind." Better to verbalize: "I will try to answer your questions & clarify some issues regarding your treatment. |
| Exploring | Helps client feel free to talk and examine issues in depth. Delving further into a subject, idea, experience, or relationship; especially helpful with clients who tend to remain on a superficial level of communication. "Please explain that situation in more detail." "Tell me more about that particular situation." |
| Advising | Telling the client what to do or how to behave implies that the nurse knows what is best & that the client is incapable of any self-direction. “I think you should call and tell your wife you are sorry.” “I think you should stop smoking now.” |
| alse Reassurance | Minimizes feelings and concerns indicating to the client that there is no cause for anxiety, thereby devaluing the client's feelings. "I wouldn't worry about that if I were you." "Everything will be all right." Better to verbalize: "We will work on that together." |
| Focusing | Helps client concentrate on a specific issue by taking notice of a single idea or even a single word; works especially well with a client who is moving rapidly from one thought to another. "This point seems worth looking at more closely. Perhaps you & I can discuss it together." |
| Giving Information | Increases clients’ involvement in plan of care, “Visiting hours are from 6pm to 8pm.” |
| Giving Recognition | Acknowledging and indicating awareness; better than complimenting, which reflects the nurse's judgment. "Hello Mr. X, I noticed that you made a ceramic ash tray in OT." "I see you made your bed." “You’ve combed your hair.” |
| Making Observations | Verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors & compare perceptions with the nurse. "You appear/seem tense." "I notice you are pacing a lot." "You seem uncomfortable when you..." |
| Offering General Leads | Offers the client encouragement to continue. "Yes, I see." "Go on." "And after that?" |
| Offering Self | Making oneself available on an unconditional basis, increasing client's feelings of self-worth "I'll stay with you awhile." "We can eat our lunch together." "I'm interested in you." |
| Reflecting | Questions & feelings are referred back to the client so that they may be recognized & accepted, & so that the client may recognize that his/her point of view was valued - good technique to use when client asks for advice. Client: "What do you think I should do about my wife's drinking problem?" Nurse: "What do you think you should do? "Patient: do you think I should tell the doctor? Nurse: Do you think you should? Patient: my brother spends all my money and then has the nerve to ask for more. Nurse: this causes you to feel angry? |
| Restating | Repeats clients’ content of interaction and encourages further discussion, Patient: I can’t sleep. I stay awake all night. Nurse: you have difficulty sleeping? |
| Seeking Clarification & Validation | Striving to explain that which is vague or incomprehensible & searching for mutual understanding; clarifying the meaning of what has been said facilitates & increases understanding for both client & nurse. "I'm not sure that I understand. Would you please explain?” "Tell me if my understanding agrees with yours." "Do I understand correctly that you said...?"Have I got this straight, you’ve said that you want to go home? |
| Approving or Disapproving | Sanction or denouncing the client's idea or behavior. "That's good. I'm glad that you..." "That bad. I'd rather you wouldn't..." Better to verbalize: "Let's talk about how your behavior invoked anger in the other client at dinner." |
