Introduction. Focusing
- The technique involves focusing on one idea or word produced by the client;
- Aimed to help in a more detailed consideration of significant thoughts (Townsend & Morgan, 2017);
- Particularly relevant when working with patients who shift from subject to subject;
- Not suitable for working with clients with a high level of anxiety (Sheikh, 2020);
- Can only be used after the level of anxiety has been reduced.
Exploring
- A more detailed consideration of any subject, idea, or aspect of the relationship;
- Most effective with clients who are prone to detach and superficial communication (Townsend & Morgan, 2017);
- It is necessary to limit exploring when the client is uncomfortable;
- Facilitates open discussion and trust building (Varcarolis & Fosbre, 2020);
- The basis of the client-centered therapeutic approach.
Seeking clarification and validation
- Used to clarify incomprehensible aspects and points presented by the client (Townsend & Morgan, 2017);
- It is aimed at finding mutual understanding and agreement between the client and the therapist (Varcarolis & Fosbre, 2020);
- Allows clarifying the meaning of what was said;
- Facilitates understanding between client and nurse (Sheikh, 2020);
- Can be used to clarify nurse statements for better mutual understanding.
Presenting reality
- Presentation of the nurse’s perception of reality to the client;
- Used when the client of the mix is interpreting events or has a distorted reality perception (Sheikh, 2020);
- Helps the client to distinguish reality from unreality (Varcarolis & Fosbre, 2020);
- Uses clarification of client’s misconceptions;
- Includes the articulation of doubts about the reality of the client’s perception of the situation.
Voicing doubt
- Based on the articulation of doubt about the reality of the client’s perception (Varcarolis & Fosbre, 2020);
- Often used when working with clients with delusional thoughts (Townsend & Morgan, 2017);
- Forces the client to reconsider their assumptions and statements;
- A gentle way to draw the client’s attention to erroneous conclusions and ideas;
- Allows the client to examine their own thoughts and feelings.
Verbalizing the implied
- Verbal articulation of what the client only implied (Townsend & Morgan, 2017);
- Can be used to work with clients who are mute (Varcarolis & Fosbre, 2020);
- Effective when working with clients who are not ready for open communication or who experience verbal impairments;
- Clarifies implicit aspects of communication;
- Includes observation of non-verbal aspects of communication (Sheikh, 2020).
Attempting to translate words into feelings
- Articulation of the exact feelings that the client expresses symbolically (Townsend & Morgan, 2017);
- The nurse is looking for clues about how the client is feeling;
- It is a way to demonstrate active listening (Townsend & Morgan, 2017);
- Allows building a more trusting relationship with the client (Sheikh, 2020);
- Used when feelings are expressed indirectly.
Formulating a plan of action
- Planning helps in reducing anxiety and stress levels;
- Planning allows the client to avoid the stress of experiencing unmanageable conditions;
- May begin with a summary of the main points of discussion (Townsend & Morgan, 2017);
- Most effective at the end of a session or interview (Sheikh, 2020);
- Used as an introduction to future care planning.
Using silence
- Implies pauses of several seconds or minutes without a verbal response;
- Allows the client to organize and analyze thoughts (Townsend & Morgan, 2017);
- Used to prepare for the development of a larger topic;
- Allows the client to take control of the discussion if necessary (Sheikh, 2020);
- The nurse should wait for the client to formulate thoughts or feelings.
Accepting
- Conveys regard and positive attitude (Townsend & Morgan, 2017);
- Creates a comfortable atmosphere for the client to express feelings;
- Helps to show empathy and concern;
- Implies the absence of judgment for any feelings of the client;
- It is especially necessary when expressing negative feelings such as anger or sadness (Sheikh, 2020).
References
Sheikh, A. A.(2020). Handbook of therapeutic imagery techniques. Routledge.
Townsend, M. C., & Morgan, K. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. F.A. Davis.
Varcarolis, E. M., & Fosbre, C. D. (2020). Essentials of psychiatric mental health nursing. Elsevier Health Sciences.