Communication

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Communication

• Therapeutic Communication and Active Listening

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Communication

• Stroke can often affect a persons ability to
  communicate ideas, wishes, thoughts and
  feelings.
• It can also affect the persons ability to
  understand an others ideas, wishes, thoughts and
  feelings.
• Changes in communication after a stroke often
  result in distress, and it is important to
  communicate in a way that is meaningful for the
  person.

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Rules for Effective Communication
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Activity

• Use the following directions to draw a picture
  (work on your own and do not ask any questions
  about the directions)
• Draw an egg shape.
• Draw a small circle touching the egg shape.
• Draw a small circle inside the circle you have
  just drawn.
• Draw three straight lines coming out of the
  circle that touch at one end.
• Repeat just below.
• Draw two longer lines coming out of the egg
  shape.
• Draw a line to join up these two lines.
• Draw three straight lines inside the shape you
  have just created.
• Draw two lines coming out of the bottom of the
  egg shape.
• Draw two short lines coming out of the lines that
  you have just drawn.
• Do not move on to the next slide until you have
  finished the above.

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Does Your Drawing Look Like This?
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Barriers to Effective Communication

• The environment
• Own circumstances, levels of stress and
  priorities
• Own personal style
• Patient characteristics

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Core Counselling Skills

• Rogers (1957) talked about core counselling
  conditions, which he thought were essential
  ingredients for a therapeutic relationship.
• Empathy - Empathy is the ability to stand in the
  patients shoes .
• Genuineness - To be real, natural and open and
  not act your job role, being spontaneous and
  willing to share your own experiences and
  feelings (this has to be done carefully!)
• Warmth - Remaining open. Not showing
  defensiveness or blame the patient or others for
  situations/events and treating everyone with
  equal worth.
• Unconditional Positive Regard - Accepting and
  valuing the person, regardless of their
  background. convey positive regard and respect
  for them

Unconditional Positive Regard
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Active Listening

• Repeating
• Select something the person has just said that
  seems important, and repeat it back to them.
• Re Phrasing
• Saying the same thing but re-wording it slightly.
• Paraphrasing
• Summing up the main points of the story to ensure
  you have picked up on all of the important
  details.
• Reflection of Feeling
• Listening to the patient and deducing from what
  they are telling you, how they are feeling.

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Dealing with Discomfort

• Contain distress, which means making the
  person feel it is ok, allowed (people often say
  sorry for crying), and safe and contained.
• Try not to take anger or frustration personally.
  It can help to reflect back the feeling It
  sounds like . . ..
• Paraphrasing and summarising can be used to draw
  out key points things you may have identified
  that the person could move forward.

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Summary

• Good communication skills are not necessarily
  something that come naturally, or easily, no
  matter what your role is and how much patient
  contact you have.
• We could all improve on our communication skills
  by using some of the techniques mentioned, but
  the most important of all is active listening.
• We asked many patients about their experiences in
  hospital following stroke and the majority of
  them said that the one thing they really could
  have done with was somebody to listen to them.