Communication Skills on Permies

I was thinking what a bunch of loonies we are here on permies and I thought this might help . All nursing students do a 6 week Psychiatric rotation . We have to try and master a skill called "Therapeutic Communication" . Designed to foster open-ended conversation while preserving dignity and self worth . Most students are vexed by this because it is an elaborate skill requiring ballet-like mental gymnastics when conducted in real time . I think there are moments when posters - myself included - would benefit from some of these tools before we reply and lose an apple or two . If we are trying to heal the planet we must also try to heal each other . By being nice . Here are some Be Nice Tips for your Interpersonal Tool Kit :

"THERAPEUTIC COMMUNICATION TECHNIQUES :

Using silence - allows client to take control of the discussion, if he or she so desires
Accepting - conveys positive regard
Giving recognition - acknowledging, indicating awareness
Offering self - making oneself available
Giving broad openings - allows client to select the topic
Offering general leads - encourages client to continue
Placing the event in time or sequence - clarifies the relationship of events in time
Making observations - verbalizing what is observed or perceived
Encouraging description of perceptions - asking client to verbalize what is being perceived
Encouraging comparison - asking client to compare similarities and differences in ideas, experiences, or interpersonal relationships
Restating - lets client know whether an expressed statement has or has not been understood
Reflecting - directs questions or feelings back to client so that they may be recognized and accepted
Focusing - taking notice of a single idea or even a single word
Exploring - delving further into a subject, idea, experience, or relationship
Seeking clarification and validation - striving to explain what is vague and searching for mutual understanding
Presenting reality - clarifying misconceptions that client may be expressing
Voicing doubt - expressing uncertainty as to the reality of client’s perception
Verbalizing the implied - putting into words what client has only implied
Attempting to translate words into feelings - putting into words the feelings the client has expressed only indirectly
Formulating plan of action - striving to prevent anger or anxiety escalating to unmanageable level when stressor recurs"


And then there is the flip side to this . This is where we lose apples and marbles :

"Nontherapeutic Communication Techniques :

Giving reassurance - may discourage client from further expression of feelings if client believes the feelings will only be downplayed or ridiculed
Rejecting - refusing to consider client’s ideas or behavior
Approving or disapproving - implies that the nurse has the right to pass judgment on the “goodness” or “badness” of client’s behavior
Agreeing or disagreeing - implies that the nurse has the right to pass judgment on whether client’s ideas or opinions are “right” or “wrong”
Giving advice - implies that the nurse knows what is best for client and that client is incapable of any self-direction
Probing - pushing for answers to issues the client does not wish to discuss causes client to feel used and valued only for what is shared with the nurse
Defending - to defend what client has criticized implies that client has no right to express ideas, opinions, or feelings
Requesting an explanation - asking “why” implies that client must defend his or her behavior or feelings
Indicating the existence of an external source of power - encourages client to project blame for his or her thoughts or behaviors on others
Belittling feelings expressed - causes client to feel insignificant or unimportant
Making stereotyped comments, clichés, and trite expressions - these are meaningless in a nurse-client relationship
Using denial - blocks discussion with client and avoids helping client identify and explore areas of difficulty
Interpreting - results in the therapist’s telling client the meaning of his or her experience
Introducing an unrelated topic - causes the nurse to take over the direction of the discussion"


Here is the link to the rest of the article :

http://nursingplanet.com/pn/therapeutic_communication.html

Good stuff, Wayne. We called it "active listening" in my time. I think I like "therapeutic communication" better.

I once tried teaching these techniques to an entire school teaching staff, in the belief that "better listening skills" could improve (and empower) teacher/student, teacher/parent and teacher/teacher communications. In turn, if communications improve, the whole environment and learning curve breaks sharply up.

Once set in place, humans are almost impossible to change. The 5% who "got it" and took it in became happier and far more effective teachers. Most of the others gave it 5 or 10 seconds of serious thought and then went back to whatever shell they found most comfortable.

So I begin to wonder if "good listeners" are born and not made? But truly, if I could change just one characteristic in humans it would be to have a deep listening skill or nature.

How to you use the insights found here?

jv

Wayne...absolutely superb information...any effective communicator whether in script or by voice would do very well to internalize your message!

When I was still a Clinical Director working with staff and kinds for our Wilderness Program, your post was the starting point of at least one of the daily three shifts...we could not have lived without them...so, so, important...

I would do well myself to revisit them more often today...

Thanks for the reminder...

j

Jay Vinekeeper asked : "How do you use the insights found here?"

In the clinical setting for example : An 80 year old man with Alzheimers disease is restless and agitated . He is wandering room to room asking everyone if we have seen his mother . This is a very common occurence . A theory I support is the man is not thoroughly confused . Deep inside he remembers he buried his mother 40 years before . His is reconciling his life as he undergoes a terminal illness . He has a need to revisit his mother in his memories . A very common response amongst nursing staff is " No , I have not seen your mother " . Hopefully , we don't repeatedly remind him his mother is dead . I have found that the use of "Exploring" is very beneficial . So , the conversation would go like this :

"What's your Mothers name , Bob ?"
"Emily Johnson"
"Was she a farmer ?"
"Oh yes , we always lived on the farm. Still do "
"Can she cook ?"

And so on . 9 times out of 10 the man is satisfied after a few minutes and is calm without medication . I have used exploring very successfully many times .

Now as far as permies.com goes .....other than using silence {or ignoring} I can't say I have practiced any skill in particular . Ha!

I love this place.

Hi Wayne, et al,

Sorry, your correct, I kinda rushed right over JV's question in my enthusiasm to see that others have used these communication skill sets and know there great value. As well, in my active time in clinical work we called it "active or focused listening"...I too feel that "therapeutic listening" is a nice addition...and for clinical work would now use the term "focused therapeutic listening." For day to day stuff with students, family, and people in genera,l I will think of it more as just "focused listening," and the benefits it does bring to the exchange.

The question, yes a good one and germane to being more effective communicators...

JV wrote:"How do you use the insights found here?"

Using silence - we called this "planned ignoring" in our clinical practice and it does indeed have impact in a written forum as well.

Accepting - Or "thought acknowledgement" has a huge impact on the reader you are sharing an exchange with...especially on an "information forum" like Permies.

Giving recognition - Very similar to "thought acknowledgement" but a step further into an offered accolade for something on note or importance.

Offering self - This one I have been relatively good at here at Permies, though one must monitor the possibility of offering guidance where now was sought (a flaw of mine that could be improved.)

Giving broad openings - By the nature of this forum and its staff...we do this by the normative culture that is Permies.

Offering general leads - We call this "steering" and it is effective in both education, and clinical work.

Placing the event in time or sequence - Not as common, yet effective to validate the chronological relationship between the topic...lets say timber framing...and how it was used and still is germane today in architecture.

Making observations - Part of the "restating" phraseology that is very useful in education as well as therapy, it lets the listener know you have taken their comment and now are sharing your thoughts about it. One must be careful thought as this has a thin edge that can crumple and also sound dismissive of the OP.

Encouraging description of perceptions - Here we ask for photos and diagrams of there questions, thoughts and concepts...very helpful and useful..

Encouraging comparison - A very good practice as long as it does not sound like asking for citations or "proof" of what they are saying. Asking a reader/poster to compare similarities and differences in their ideas, experiences, or interpersonal relationships is useful in getting to understand there foundational skill sets and knowledge base.

Restating - Employed in the same context and modality as "making observations."

Reflecting - Similar, again, to the above, yet must be performed more delicately as this can be construed as "condescension" if not written well.

Focusing - I do use this very often with posters trying desperately to ask a series of difficult and technical questions and all they really need is a simple of "focus answer" thereby allowing them to colles their own thinking and where they may understand the challenges before them more clearly.

Exploring - Here we can do a great service by taking the topic of the OP into a deeper understanding than they may currently possess, thereby broadening the conversation and the individual readers understanding of the topic.

Seeking clarification and validation - This is very similar to "encouraging descriptions of perception." This is the next level of that, usually deeper into the conversation within a OP topic. understanding

Presenting reality - Very crucial, yet one to tread lightly with. Many OP do not believe they possess "misconceptions" and when a perceived "authority figure" attempts this "presenting reality" can aggravate certain personality types...as we all know too well. It is still important to do this often as we do not want to allow other less demonstrative readers believe a "misconception" is a "reality" in general...it just may be the conclusion that one person has, not a contextual reality in the body of the works or topic.

Voicing doubt - Almost a verbatim response in its application to what we do (or should do) with "presenting reality." Each of us have different "realities" and "doubts."

Verbalizing the implied - We called this in clinical work "restating" and it is a deep and broad modality of communication that could entail many different levels of use. Here I will often restate the "implied" question or comment, in a clearer context.

Attempting to translate words into feelings - Very useful by taking the OP question, or comment and (when applicable) putting into language that is either clearer or less charged with emotion. Some topics move from the technical cognitive abilities of an OP or reader and into emotional reactions to the topic of discussion. Being able to facilitate a conversation from an emotional state into a cognitive one within the reader or OP allows (when it can actually happen) the chance for perhaps a paradigm shift in their thinking.

Formulating plan of action - In clinical work, this too had many levels fro "active planning" to "coping skill sets listing" and many more. Here we use it, again, to colaless a reader or OP's concepts into a viable and executable plan...

Wayne Stephen wrote:This is where we lose apples and marbles :

Before I ramble on into this list, and its pit falls, I should ask if what I just wrote was of any value to the current readers...?

"Non-Therapeutic Communication Techniques :

Giving reassurance - may discourage client from further expression of feelings if client believes the feelings will only be downplayed or ridiculed
Rejecting - refusing to consider client’s ideas or behavior
Approving or disapproving - implies that the nurse has the right to pass judgment on the “goodness” or “badness” of client’s behavior
Agreeing or disagreeing - implies that the nurse has the right to pass judgment on whether client’s ideas or opinions are “right” or “wrong”
Giving advice - implies that the nurse knows what is best for client and that client is incapable of any self-direction
Probing - pushing for answers to issues the client does not wish to discuss causes client to feel used and valued only for what is shared with the nurse
Defending - to defend what client has criticized implies that client has no right to express ideas, opinions, or feelings
Requesting an explanation - asking “why” implies that client must defend his or her behavior or feelings
Indicating the existence of an external source of power - encourages client to project blame for his or her thoughts or behaviors on others
Belittling feelings expressed - causes client to feel insignificant or unimportant
Making stereotyped comments, clichés, and trite expressions - these are meaningless in a nurse-client relationship
Using denial - blocks discussion with client and avoids helping client identify and explore areas of difficulty
Interpreting - results in the therapist’s telling client the meaning of his or her experience
Introducing an unrelated topic - causes the nurse to take over the direction of the discussion"



Regards,

j

Bump! Here are some resources I found online about communication:

Here is a TEDtalk by Julian Treasure about speaking:


Here is an article by HelpGuide about effective communication.