Key Takeaways
- Therapeutic communication is purposeful communication that promotes healing and patient well-being
- Active listening involves verbal and nonverbal cues that show genuine interest and understanding
- Open-ended questions encourage patients to share more information and feelings
- Therapeutic silence gives patients time to gather thoughts and can be powerful in emotional situations
- Non-therapeutic techniques such as false reassurance, judgment, and giving advice should be avoided
Last updated: January 2026
Therapeutic Communication Techniques
Therapeutic communication is purposeful, goal-directed communication that promotes patient well-being. The LPN/LVN uses these skills in every patient interaction to build trust, gather information, and support healing.
Principles of Therapeutic Communication
Key Elements:
- Patient-centered focus
- Purposeful and goal-directed
- Builds trust and rapport
- Maintains professional boundaries
- Respects patient autonomy
Therapeutic Techniques
| Technique | Description | Example |
|---|---|---|
| Active listening | Fully attending to patient's message | Maintaining eye contact, nodding, leaning forward |
| Open-ended questions | Questions that require more than yes/no | "Tell me about your pain." |
| Reflection | Repeating back patient's words or feelings | "You feel frustrated about your diagnosis?" |
| Clarification | Asking for more information to understand | "What do you mean when you say 'dizzy'?" |
| Restating | Paraphrasing what patient said | "So you're saying the pain started after surgery." |
| Summarizing | Reviewing main points | "Let me make sure I understand..." |
| Silence | Allowing quiet time for processing | Sitting quietly while patient gathers thoughts |
| Focusing | Directing conversation to specific topic | "Let's talk more about your medication concerns." |
| Giving information | Providing factual information | "Your surgery is scheduled for 8 AM." |
| Validation | Acknowledging patient's feelings | "It's understandable to feel anxious about surgery." |
Active Listening
Components of Active Listening:
| Component | Description |
|---|---|
| Attending | Giving full attention, facing patient |
| Observing | Noting nonverbal cues |
| Listening | Hearing words and underlying meaning |
| Responding | Verbal and nonverbal feedback |
| Remembering | Retaining information for continuity |
SOLER Technique:
- S - Sit facing the patient
- O - Open posture (uncrossed arms/legs)
- L - Lean toward the patient
- E - Eye contact (culturally appropriate)
- R - Relax and be natural
Non-Therapeutic Techniques (Avoid)
| Technique | Why It's Harmful | Example |
|---|---|---|
| False reassurance | Dismisses concerns, may not be true | "Don't worry, everything will be fine." |
| Giving advice | Takes away patient autonomy | "If I were you, I would..." |
| Judgment | Makes patient feel criticized | "You shouldn't have waited so long." |
| Approval/disapproval | Patient may try to please nurse | "I'm so proud you quit smoking." |
| Defending | Shuts down communication | "Your doctor is excellent." |
| Changing subject | Avoids patient's concerns | Shifting topic when patient becomes emotional |
| Stereotyping | Ignores individuality | "Old people are always confused." |
| Asking "why" | Puts patient on defensive | "Why didn't you take your medication?" |
| Belittling | Minimizes patient's experience | "Other patients have worse problems." |
| Agreeing | May prevent honest discussion | "You're right, that nurse was terrible." |
Communication Barriers
| Barrier | Strategy to Overcome |
|---|---|
| Language differences | Use professional interpreters |
| Hearing impairment | Face patient, speak clearly, reduce background noise |
| Visual impairment | Identify yourself, describe environment |
| Cognitive impairment | Simple sentences, allow time, reduce distractions |
| Pain/discomfort | Address pain first if possible |
| Anxiety | Use calming tone, provide information |
| Cultural differences | Be aware of cultural norms, ask preferences |
Nonverbal Communication
Types of Nonverbal Cues:
- Facial expressions
- Eye contact
- Body posture
- Gestures
- Touch
- Tone of voice
- Personal space
Nursing Considerations:
- Nonverbal messages must match verbal
- Observe patient's nonverbal cues for additional information
- Cultural variations affect interpretation
- Your nonverbal communication affects patient comfort
Communication with Specific Populations
| Population | Strategies |
|---|---|
| Children | Get on their level, use simple words, involve play |
| Adolescents | Respect privacy, be honest, avoid lecturing |
| Older adults | Allow time, reduce distractions, face patient |
| Anxious patients | Calm voice, provide information, acknowledge feelings |
| Angry patients | Stay calm, listen, validate feelings, set limits |
| Grieving patients | Be present, use silence, avoid clichés |
Professional Boundaries
Maintain boundaries by:
- Keeping conversation patient-focused
- Avoiding excessive self-disclosure
- Maintaining appropriate physical boundaries
- Not engaging in dual relationships
- Recognizing and addressing boundary crossings
On the NCLEX-PN
Expect questions about:
- Identifying therapeutic vs. non-therapeutic responses
- Choosing the best response to patient statements
- Recognizing barriers to communication
- Applying techniques to specific situations
Test Your Knowledge
A patient says, "I'm so scared about my surgery tomorrow." Which response by the LPN is most therapeutic?
A
B
C
D
Test Your Knowledge
The LPN is caring for a patient who begins crying while talking about a recent loss. Which action is most appropriate?
A
B
C
D
Test Your Knowledge
A patient asks the LPN, "Do you think I should have this surgery?" The most therapeutic response is:
A
B
C
D