Introduction
Stube (2018) explains that a therapeutic relationship aims at answering the vital questions; how can a nurse treat or positively influence the life and well-being of a patient? This implies how a medical practitioner can establish a relationship with a patient to improve the patient’s well-being. The author continues to explain that the quality of the therapeutic relationship between a nurse and the patient influences the outcome of patient care. The therapeutic relationship is the feelings and attitudes experienced by therapists and patients and the expression of such experiences (Nunez et al., 2022). It entails three significant areas; the patient’s and the nurse’s agreement on the treatment goals and process of treatment, the bond between the patient and the therapist, and the collaborative benefits of the relationship.
An effective therapeutic relationship (TR) entails silence, empathy, open-ended questions, unconditional acceptance, and attending and listening skills. Therapists demonstrate silence during the Interview with the patient. It is one of the most valued skills as it ensures the patient has enough time to speak without interruptions, alongside giving the practitioner enough time to understand the patient and think about what to say next. Empathetic listening is demanded while engaging with the patient in an interview. It entails having the same feelings as the person but not feeling for the person. It implies being in the patient’s shoes. According to Texas University (2019), empathy promotes patient care, improved patient satisfaction, enhanced communication, and high patient compliance with the treatment process.
Open-ended questions give the patient enough room to expand on their health condition and provide sufficient information. Unconditional acceptance demands that therapists help patients regardless of their social class, ethnic background, and nature of the illness or disease. Lastly, attending and listening require the therapist to consider the patient’s physical environment, which entails privacy. Attending and listening also encompasses the sitting posture of the therapist and good listening skills such as active listening. The above skills have been demonstrated differently by the therapists in the videos. This discussion focuses on an in-depth analysis of two therapeutic skills based on the two videos (excellent and poor Interviews), how they have been demonstrated by the therapists, and their importance in nursing practice.
Body
Brailon & Taibei (2020) posit that empathy is a client-centered therapy. Empathetic feeling enables the therapist to develop a strong connection with the patient since the practitioner focuses on the patient-centered approach, developing strong communication based on the patient’s treatment and recovery process. Empathy encompasses cognitive, behavioral, and emotional dimensions (Moudatsou et Al., 2020). The mental aspect focuses on understanding the patient’s perspective, the behavioral part entails effective communication (the effective use of verbal and non-verbal communication techniques), and lastly, the emotional domain entails resonating with a patient emotionally.
Attending and listening is a significant factors in the therapeutic process. Patients feel cared for when therapists treat them physically. In a physical meeting, the therapist should be aware of the physical location and surroundings of the patient to observe privacy. The therapist should ensure the patient’s information is private and kept confidential. Both interviewers demonstrate this skill. In the first video, the interviewer confirmed that there was no other patient in the room of the Interview and notified the patient about the information recorded, and let the patient be aware of what they would do with the data. The second video (poor Interview) needs to include the last statement.
Interviewer: We will look at your previous history and what is happening to you…
Client: Okay
(From 7. 14 to 7. 29)
The excellent interview video shows that the interviewer is very caring and attentive. Initially, she welcomes the patient and helps her put aside the scratches. The interviewer asks if she can help the client put the crutches safely, and she goes on to ask if the legs are painful (from 0.16 to 0.31). The environment for the Interview was calm, and no instances of interruptions were noticed. Through this, the therapist had the full attention of the patient. This is seen in the two videos.
Posture is also one of the wings of attending and listening. The therapist is expected to maintain an upright posture when dealing with the patient to show concern and commitment toward the patient. The therapist should maintain meaningful eye contact with the patient and lean forward with a relaxed posture. Maintaining appropriate body language is vital in a therapeutic session. It focuses on the patient’s and therapist’s movements and behaviors during the interview session (Abdulghafor et Al., 2022).
Croft et Al. (2022) assert that active listening by the therapist shows concern, understanding, and caring. It helps in building a solid client-therapist relationship during the therapeutic process. Through active listening, the patient develops a perception towards the therapist and notes the clinician’s use of verbal behaviors. Verbal behaviors are encompassed in active listening. One of the components of active listening is restating or paraphrasing what the patient says. The ‘good interview video’ interviewer employed this technique in the two videos.
According to the American Psychological Association (n.d), active listening also entails asking relevant questions to understand the client’s message and interpret their emotions fully. The interviewer in the ‘good interview’ engaged in active listening by asking the patient questions, and through the responses, she could have understood the patient well and the patient’s emotions. Additionally, she kept motivating the client to speak up by nodding where necessary. She used words such as ‘fantastic’ to assure the client she was fully involved in the conversation.
Active listening also involves the speaker’s tone of voice, timing, speed of talking, and facial expressions demonstrated by the therapist. Warning, commanding, shaming, probing, and distracting are considered inactive and poor listening. The interviewer in the second video does not show active listening. The body posture she uses is demeaning and discouraging. She presents herself while chewing something, which offers a lack of professionalism. The interviewer in the ‘good interview video” has ensured good timing and allowed the client to speak up without interruptions. Her speed of talking is also encouraging. The observations are different from the poor Interview. The interviewer in the poor Interview fails to show empathetic feelings right from the time the client enters the room to the end of the Interview. In addition, the interviewer also demonstrates inappropriate facial expressions regarding the scenario.
A good interview is recommended. The therapist makes good use of therapeutic components. She acknowledges the patient by welcoming her and offers to keep her crutches. She says,
Interviewer: Hi Sharon, come and sit here.
Client: Thank you.
Interviewer: Can I help you with those?
Client: Okay
(From 0.14 to 025).
Conclusion
Empathy constitutes a very significant component of communication skills in the therapeutic process. However, most medical practitioners find it challenging to adopt the empathetic communication model due to the ever-increasing number of patients, inadequate time, and limited education on the role of empathy in nursing practice. Compassionate communication employs a client-centered approach in dealing with patients hence should be adopted by health practitioners. Additionally, nurses and other medical practitioners should be subjected to thorough empathy lessons to apply the skill appropriately and effectively.
On the other hand, active listening has proved to be a vital component in the therapeutic process. It helps to build and maintain therapeutic bonds by demonstrating empathy and improves the chances of one’s recovery. Through emotions displayed by the therapist, the client feels comforted and encouraged hence embracing her condition positively. Active listening can be applied to change negative mindsets to positive ones. Active listening and empathetic listening demand the full attention of the therapist. Showing empathy and engaging in active listening motivates the patient to accept positivity, thus improving patient outcomes. Comparing the two videos, the patient in the ‘good interview video’ will likely recover faster than the other patient because the first interviewer has utilized the vital components of therapeutic counseling, which are missing in the ‘poor interview.’
References
Abdulghafor. R., Turaever. S., & Ali. M., (2022, July). Body Language Analysis in Healthcare: An Overview. https://doing.org/10.3390/healthcare10071251
American Psychological Association, (2022, June 19). Active Listening. In APA Dictionary of Psychology.https://dictionary.apa.org/active-listening
Brailon. A., & Taiebi, F., (2020). Practice “Reflective Listening” is a Mandatory Prerequisite for Empathy. Patient Education and Counselling, 103(9), 1866-1867. https://doi.org/10.1016/j.pec.2020.03.24
Croft. R., Byrd. C., & Kelly. E., (2022, October 29). The Influence of Active Listening on Parents’ Perceptions of Clinical Empathy in a Stuttering Assessment: A Preliminary Study. https://doing.org/10.1016/j.jcomdis.2022.106274
Moudatsou. M., Stavropoulou. A., Philalithis. A., & Koukouli.S., (2020, March). The Role of Empathy in Health and Social Care Professionals. https://doing.org/10.3390/healthcare8010026
Nunez. L., Fernandez. S., Alamo. N., Midgley. N., Krause. M., & Capella. C., (2022 February 4). https://doing.org/10.4081/ripppo.2022.556
Stubbe. D., (2018, October 18). The Therapeutic Alliance: The Fundamental Element of Psychotherapy. https://doing.org/10.1176/appi.focus.20180022
Texas International University, (2019, May 15). Why Empathy is Crucial in Nursing. https://online.tamiu.edu/articles/rnbsn/empathy-is-crucial-in-nursing.aspx
write