Nontherapeutic Communication 

Example

Rationale

Reassuring   

-Indicting there is not cause for anxiety.

“Everything will be all right.”

“I wouldn’t worry about that!”

1. Attempts to dispel the anxiety of the patient by implying there is not sufficient reason for it devalues the patient’s judgment, and communicated the nurse’s lack of understanding and empathy.

2. Concrete examples of patient progress can be commented on rather than general reassurances.

3. Reassurance makes the nurse feel better at the time but is meaningless to the patient.

4. The person giving the reassurance cannot be sure that the predicted favorable outcome will occur. 

5. Reassurances block expression of feelings.

Giving approval   

-Sanctioning the patient’s ideas or behaviors.

“That’s good.”

“I’m glad that you…”

1. Statement of the “good” implies the opposite is “bad”.

2. Approval limits the freedom of the patient to act in a way that displeases the nurse.

3. Approval leads the patient to strive for praise rather that progress.

4. Approval arouses undue ambition, competitiveness, and a sense of superiority.

5. Approval blocks learning.

6. Approval and disapproval may alter undesirable behavior, but usually only temporarily.

Rejecting

“Let’s not discuss . . .”

“I don’t want to hear about . . .”

Correction: “Let’s look at that a little closer.”

1. Refusing to consider or showing contempt for the client’s ideas or behavior. 

2. This may cause the client to discontinue interaction with the nurse for fear of further rejection.

Sanctioning or denouncing

“That’s good. I’m glad that you . . .”

“That’s bad.  I’d rather you wouldn’t . . .”

Correction: “Let’s talk about how your behavior invoked anger in the other clients at dinner.”

1. The client’s ideas or behavior; implies that the nurse has the right to pass judgment on whether the client’s ideas or behaviors are “good” or “bad” and the client is expected to please the nurse.

2. The nurse’s acceptance of the client is then seen as conditional, depending on the client’s behavior

Agreeing/disagreeing

“That’s right.  I agree.”

“That’s wrong.  I disagree.”

“I don’t believe that.”

Correction: “Let’s discuss what you feel is unfair about the new community rules.”

1. Indicating accord with or opposition to the client’s ideas or opinions; implies that the nurse has the right to pass judgment on whether the client’s ideas or opinions are “right” or “wrong”. 

2. Agreement prevents the client from later modifying his or her point of view without admitting error.  Disagreement implies inaccuracy, provoking the need for defensiveness on the part of the client.

Giving advice

“I think you should . . .”

“Why don’t you . . .”

Correction: “What do you think you should do?”

1. Telling the client what to do or how to behave implies that the nurse knows what is best and that the client is incapable of any self-direction. 

2. It nurtures the client in the dependent role by discouraging independent thinking.

Probing

“Tell me how your mother abused you when you were a child.”

“Tell me how you feel toward your mother now that she is dead.”

“Now tell me about . . .”

Correction: The nurse should be aware of the client’s response and discontinue the interaction at the first sign of discomfort.

1. Persistent questioning of the client; pushing for answers to issues the client does not wish to discuss. 

2. This causes the client to feel used and valued only for what is shared with the nurse and places the client in the defensive.