Phases of Therapeutic Nurse-Patient Relationships

Phases of Therapeutic Nurse-Patient Relationships

  • Pre-interaction phase
    • Obtain information about the patient from chart, significant others, or other health team members.
    • Examine one’s own feelings, fears, and anxieties about working with a particular patient.
  • Orientation (introductory) phase
    • Create an environment for trust and rapport.
    • Establish contract for intervention.
    • Gather assessment data and identify patient’s strengths and limitations.
    • Formulate nursing diagnoses and set mutually agreeable goals.
    • Develop a realistic plan of action.
    • Explore feelings of both patient and nurse.
  • Working phase
    • Maintain trust and rapport.
    • Promote patient’s insight and perception of reality.
    • Use problem-solving model to work toward achievement of established goals.
    • Overcome resistance behaviors.
    • Continuously evaluate progress toward
      goal attainment.
  • Transference: Occurs when the patient unconsciously displaces (or “transfers”) to the nurse feelings formed toward a person from the past
  • Countertransference: Refers to the nurse’s behavioral and emotional response to the patient
  • Termination phase
    • Therapeutic conclusion of relationship occurs when
    • Progress has been made toward attainment of the goals.
    • A plan of action for more adaptive coping with future stressful situations has been established.
    • Feelings about termination of the relationship are recognized and explored.


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