THERAPEUTIC COMMUNICATION A distinguishing aspect of therapeutic communication is its application to long-term communi- cation interactions. Therapeutic communication is defined as the face-to-face process of interacting that focuses on advancing the physical and emotional well-being of a patient. This kind of communication has three general purposes: collecting information to determine illness, assessing and modifying behavior, and providing health education. By using therapeutic communication, we attempt to learn as much as we can about the patient in relation to his illness. To accomplish this learning, both the sender and the receiver must be consciously aware of the con- fidentiality of the information disclosed and received during the communication process. You must always have a therapeutic reason for invading a patient’s privacy. When used to collect information, therapeutic communication requires a great deal of sensitivity as well as expertise in using interviewing skills. To ensure the identification and clarification of the patient’s thoughts and feelings, you, as the interviewer, must observe his behavior. Listen to the patient and watch how he listens to you. Observe how he gives and receives both verbal and nonverbal responses. Finally, interpret and record the data you have observed. As mentioned earlier, listening is one of the most difficult skills to master. It requires you to maintain an open mind, eliminate both internal and external noise and distractions, and channel attention to all verbal and nonverbal messages. Listening involves the ability to recognize pitch and tone of voice, evaluate vocabulary and choice of words, and recognize hesitancy or intensity of speech as part of the total communication attempt. The patient crying aloud for help after a fall is communicating a need for assistance. This cry for help sounds very different from the call for assistance you might make when requesting help in transcribing a physician’s order. The ability to recognize and interpret nonverbal responses depends upon consistent development of observation skills. As you continue to mature in your role and responsibilities as a member of the healthcare team, both your clinical knowledge and understanding of human behavior will also grow. Your growth in both knowledge and understanding will contribute to your ability to recognize and interpret many kinds of nonverbal communication. Your sensitivity in listening with your eyes will become as refined as—if not better than—listening with your ears. The effectiveness of an interview is influenced by both the amount of information and the degree of motivation possessed by the patient (interviewee). Factors that enhance the quality of an interview consist of the participant’s knowledge of the subject under consideration; his patience, temperament, and listening skills; and your attention to both verbal and nonverbal cues. Courtesy, understanding, and nonjudgmental attitudes must be mutual goals of both the interviewee and the interviewer. Finally, to function effectively in the therapeutic communication process, you must be an informed and skilled practitioner. Your development of the required knowledge and skills is dependent upon your commitment to seeking out and participating in continuing education learning experiences across the entire spectrum of healthcare services. PATIENT EDUCATION LEARNING OBJECTIVE: Recognize the importance of patient education. Patient (health) education is an essential part of the healthcare delivery system. In the Navy Medical Department, patient education is defined as “the process that informs, motivates, and helps people adapt and maintain healthful practices and life styles.” Specifically, the goals of this process are to  assist individuals acquire knowledge and skills that will promote their ability to care for themselves more adequately;  influence individual attitudinal changes from an orientation that emphasizes disease to an orientation that emphasizes health; and  support behavioral changes to the extent that individuals are willing and able to maintain their health. All healthcare providers, whether they recognize it or not, are teaching almost constantly. Teaching is a unique skill that is developed through the application of principles of learning. Patient teaching begins with an assessment of the patient’s knowledge. Through this assessment, learning needs are identified. For example, a diabetic patient may have a need to learn how to self-administer an injection. After the learner’s 2-9