5 Therapeutic Communication Strategies for the Mentally Ill Client

Therapeutic communication is one of the most difficult things for nurses to master when caring for those who are trying to cope with the stressors of disease, illness, and even the loss of life. Finding the right things to say in times of great distress is one of the key elements in establishing a therapeutic relationship.
Implementing therapeutic communication strategies for those who may have impaired coping mechanisms is essential in facilitating a safe and therapeutic environment. Here are five therapeutic communication strategies for the mentally ill client:

  • Therapeutic communication starts with acknowledging pain

    One of the first things that a nurse should focus on is gaining the client’s trust and cooperation. The best way to do this is to begin by creating a therapeutic relationship that focuses on understanding and acceptance. When a client shares their feelings, it is essential for the nurse to acknowledge them and encourage the client to express them. By validating a client’s anxieties, frustrations, and pain, the nurse enters into a therapeutic relationship with the client.

  • Let client decide on the topic of conversation

    Letting the client decide on the direction of the conversation is another way that nurses can help promote therapeutic communication. Nurses should avoid focusing on the very first thing that caught their attention, and allow the client to speak about whatever comes to mind. When the client starts sharing, this may a good time for the nurse to explore the client’s thoughts in more detail.

  • Remain neutral in response to a client’s words and actions

    Although some nurses find it difficult to remain neutral to that of a client’s actions, beliefs, feelings and values, neutrality is essential to promote therapeutic communication. When nurses agree with what a client just shared, it may influence the client’s perception of what is acceptable, which may not reflect the values of the client but that of the nurse. This could also influence the client to modify their behaviors based on the client’s assumption that the accepted values will be used to judge the client’s behaviors. On the other hand, disagreeing with a client’s’ actions and feelings is imposing the nurse’s own beliefs onto the clients, which may lead to intimidation, anger, mistrust, and termination of the established therapeutic relationship.

  • Become comfortable with moments of silence

    In many circumstances, silence is more appropriate than the most carefully thought out response. Silence can slow down the discussion and provide the client with time for reflection and clarity of their thoughts. The nurse can use the end of a period of silence to help refocus clients by helping them to the part where they left off, or by asking them to share what they were thinking. By providing periods of silence, the nurse is showing the client that they are invested in listening to the client, and allowing the client time to shift the conversation in their preferred direction.

  • Use positive body language to demonstrate your care

    Positive body language is an important tool to promote a therapeutic relationship. Using appropriate body language gives the client a sense that you are an active listener and receptive to what they are saying. Examples of positive body language include: facing the client, moving closer to the client as they speak, making eye contact, avoiding crossing your arms, using an open posture, and using friendly gestures or nods to let the client know that you are invested in the conversation. If the client feels that you are uninterested, afraid, or that you are not invested in the conversation, an established therapeutic relationship may be compromised.

Damion Jenkins is a nurse education consultant and adjunct nursing professor in Baltimore, Maryland. He enjoys teaching a variety of healthcare courses, including: Nursing, Certified Nursing Assistant, Geriatric Nursing Assistant, Certified Patient Care Technician, IV Therapy, Phlebotomy, Certified Medicine Aide, and Nurse Refresher. His passion for enhancing the nursing profession has led him to become an active nurse blogger, author for nursing continuing education, and a private tutor. Damion graduated from the Community College of Baltimore County in 2010, and then earned a master’s degree in nursing education from Walden University in 2014.