HPR 450
Chapter 6
COMMUNICATION SKILLS
INTERPERSONAL COMMUNICATION
Without these effective interpersonal
communication skills the TR Process is doomed
to failure
 Listening
 Counseling
 Leader communication
 Interviewing
 Clients with special needs

Communication skills are used in all parts of
our lives
 Communication process includes 5 elements

 Communicator
- Who
 Message – Says What
 Medium – In What Way
 Receiver - To Whom
 Feedback – With What Effect
VERBAL COMMUNICATION

Four Factors
 Presentation
of the material in terms of Vocabulary
and Clarity
 Speaker’s attitude – Concern and caring
 Voice tone and volume - Tone of voice (inflection)
 Speaker’s and Receiver’s ability to listen
EFFECTIVE LISTENING SKILLS
Attending – (eye contact, posture, gestures,
verbal behavior)
 Paraphrasing – restated in similar but fewer
words
 Clarifying – I’m confused…would you go over
that again?
 Perception Checking – “You seem to be happy.
Is that right?”

TABLE 6-1
ATTENTIVE LISTENING USING ACRONYM “SOLER”
S − Sit squarely facing the clients.
O − Observe an open posture. (arms and legs
uncrossed)
L − Lean forward toward the client.
E − Establish eye contact.
R − Relax.
Source: Adapted from Egan, G. (2002). The skilled helper: A problem management approach to helping (7th edition). Pacific
Grove, CA: Brooks/ Cole Publishing Company & Townsend, M. C. (2000). Psychiatric mental health nursing: Concepts of care (3rd
edition). Philadelphia: F. A. Davis Company.
VERBAL TECHNIQUES FOR HELPING
PROFESSIONALS TO EMPLOY – TABLE 6-2

Minimal verbal responses

Informing

Paraphrasing

Summarizing

Checking out

Self-disclosing

Focusing

Making observations

Suggesting

Closed questions

Facilitative questions and
statements


Clarifying
Probing

Reflecting

Interpreting

Confronting
Effective communication in success-failure
situations demands appropriate approaches from
the leader
 Understanding nonverbal communication is a
critical skill for Helping professionals because
approx 2/3 of communication is nonverbal
 Following guidelines may prove to be helpful when
communicating with persons with special needs
(e.g., visually and/or hearing impaired)
 Interviewing skills are basic for the CTRS

TABLE 6-3
GENERAL GUIDELINES FOR USING MAJOR
VERBAL TECHNIQUES
1.
Phrase your response in the same vocabulary that the client uses.
2.
Speak slowly enough that the client will understand each word.
3.
Use concise rather than rambling statements.
4.
Relate the topic introduced by the client to the identified cognitive theme
that is of most importance.
5.
Talk directly to the client, not about him or her.
6.
Send “I” statements to “own” your feelings, and allow the client to reject,
accept, or modify your messages.
7.
Encourage the client to talk about his or her feelings.
8.
Time your responses to facilitate, not block, communication.
Adapted from: Okun, B.F. (2002/ Effective helping: Interviewing and counseling techniques (6th ed.). Pacific Grove, CA:
Brooks/Cole.
TABLE 6-4
FACILITATIVE QUESTIONS AND STATEMENTS
Type
Example
Observe—to notice what
went on or what goes
on.
“Tell me about yourself.”
“Tell me every detail from the
beginning.”
“To what degree do you feel that
way?”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-4
FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)
Type
Example
Describe—to stimulate
recall and details of a
specific event or
experience.
“What did you feel at the time?”
“What happened just before?”
“How did he respond to your
comment?”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-4
FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)
Type
Example
Analyze—to review that
information for greater
understanding.
“What is the importance of
event?”
“What do you see as the
reason?”
“What was your part in it?”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-4
FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)
Type
Formulate—to restate in
a clear, direct way the
relationship between
thoughts, feelings, and
experiences.
Example
“Tell me again.”
“What would you say was the
problem?”
“Can you tell me the essence of
it?”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-4
FACILITATIVE QUESTIONS AND STATEMENTS (CONT.)
Type
Test—to try out new
thoughts, feelings, or
behaviors.
Example
“What would you do if a situation
like that came up again?”
“In what way will this
understanding help you in the
future?”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-5
BARRIERS TO THERAPEUTIC COMMUNICATION
Barriers
Non-Therapeutic Examples
Giving advice
“If I were you…”
Giving false
reassurance
“Don’t worry—everything will be
OK.”
Topic jumping (changing
the subject)
“Let’s wait on that and talk
about…”
Interrupting
“Hold it, hold it!”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-5
BARRIERS TO THERAPEUTIC COMMUNICATION (CONT.)
Barriers
Non-Therapeutic Examples
Being judgmental
“You’re wrong.”
Blaming
“It is all your fault.”
Giving directions
“Just do what I say.”
Excessive questioning
“What is the real reason?”
Challenging
“You can’t really hear the devil
speaking.”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-5
BARRIERS TO THERAPEUTIC COMMUNICATION (CONT.)
Non-Therapeutic Examples
Barriers
Expressing disapproval
“I don’t approve of that.” (or
frowning)
Hurried approaches
“Will you please hurry up.”
Closed-mindedness,
Stereotyped responses
“That’s the only way to see it.”
“Keep your chin up; it won’t be
much longer.”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-5
BARRIERS TO THERAPEUTIC COMMUNICATION (CONT.)
Barriers
Non-Therapeutic Examples
Double messages
“Tell me more.” (While nonverbals show lack of interest.)
Defending or defensive
responses
Self-preoccupation or
daydreaming
Patronizing
“Don’t blame me; you’re the one
with problems.”
“Oh, excuse me; could you repeat
that? I didn’t hear what you
said.”
“Now, Honey, it will work out.”
Adapted from: Haber, J. (1997). Therapeutic communication. In J. Haber, B. Krainovich-Miller, A.L. McMahon & P. Price-Hoskins
(Eds.), Comprehensive Psychiatric Nursing (5th ed.). St. Louis: Mosby (pp. 121-142).
TABLE 6-6
COMMUNICATION WITH CLIENTS WITH SPECIAL NEEDS

Clients Who Are Visually Impaired

Clients Who Are Hearing Impaired

Clients Who Use Wheelchairs

Clients Who Speak a Foreign Language
TABLE 6-7
TECHNIQUES FOR THE PRODUCTIVE INTERVIEW

Establish rapport

Control the external environment

Wear clothing that conveys the image of a professional and is
appropriate for the situation.

Begin by stating and validating with the client the purpose of the
interview.

Use a vocabulary on the level of awareness or understanding of
the person.
Source: Murray, R.B., & Huelskoetter, M.M.W. (1991). Psychiatric/mental health nursing (3rd ed.). Norwalk, CT: Appleton &
Lange: pp.139.
TABLE 6-7
TECHNIQUES FOR THE PRODUCTIVE INTERVIEW (CONT.)

Avoid preconceived ideas, prejudices, or biases.

Be precise in what you say, so the meaning is understood.

Avoid asking questions in ways that get only socially acceptable
answers.

Be gentle and tactful when asking questions about home like or
personal matters.

Be an attentive listener.
Source: Murray, R.B., & Huelskoetter, M.M.W. (1991). Psychiatric/mental health nursing (3rd ed.). Norwalk, CT: Appleton &
Lange: pp.139.
TABLE 6-7
TECHNIQUES FOR THE PRODUCTIVE INTERVIEW (CONT.)

Carefully observe nonverbal messages for signs of anxiety, frustration,
anger, loneliness, or guilt.

Encourage spontaneity.

Ask questions beginning with “What…?” “Where…?” “Who…?” and
“When…?”

Keep data obtained in the interview confidential and share this information
only with the appropriate and necessary health team members.

Evaluate the interview.
Source: Murray, R.B., & Huelskoetter, M.M.W. (1991). Psychiatric/mental health nursing (3rd ed.). Norwalk, CT: Appleton &
Lange: pp.139.