Therapeutic Conversation Process


TherapeuticConversation Process


TherapeuticConversation Process

J.M 17thOctober 2014

BriefHistory or Scenario and Description of Setting: J.M, a 25 yearold female student and a good friend of me, seems to be in perfectlygood health. However, she has been suffering from an eating disorderand she has decided to disclose it to me. The setting is in theschool park, an ideal place with fresh air, and we pick a bench nextto a tree, and J.M sits facing me at a comfortable distance, with theability to make good eye contact.

What I Said and Did (Verbal and Nonverbal Communication)

My Thoughts and Feelings

What the Client Said and Did

Identification of Communication Techniques and Phases of Interaction

Reviewed phases of interaction and therapeutic techniques.] [Put my school satchel down and put away my books and looked for a place where we might be comfortable and private.]

T: am I going to be of help?

Am I going remember everything that is said?

F: worried

And Anxious

Pre-interaction Phase: Only phase without client interaction. Preparation of psychological and physical environment to facilitate relaxed communication and exploration of feelings.

“Ok J.M, this seems like a perfect spot for us to talk about what is bothering you. As you know I am a nursing student and well capable of helping you out.” [little smile] “Additionally, Everything we talk about will be confidential between you, me, and the professor grading my paper.” [smile, folded hands][vocal tone higher than normal]”

T: I hope she opens up

F: Nervous

“okay” [continues nodding as if to indicate continued understanding]

Clarifying Purpose of Interaction


Establishing confidentiality

”so what going on? What would you like to talk about?” [establishing eye contact]

T: I am ready for the business of the day!

F: ready

[looking over her shoulder]

“My eating Habits”

Introduction Phase

Broad Opening (Therapeutic) – Allows client to be in control.

“Okay, what about you’re eating habits” [still looking her in the face].

T: is she going to open up

F: hopeful

“I think I have developed a negative attitude towards food”

Clarification (Therapeutic): Allows client to expand on topic of choice.

“Why is this?”

[silence, allowing her to open up]

T: do she know the root cause

F: concerned

“I think I have an obsession!” [pausing]

“I just want to keep my weight as low as possible”

Reflection (Therapeutic): Enables client to reflect on feelings.

Silence: A therapeutic listening response. The person asking the questions remains quiet in order to allow the other person to continue talking if it seems like there is more information the person may want to say on the topic. This technique should be used judiciously.

“I am sorry you feel frustrated. Tell me more about your frustration?”

[leaning forward]


F: sympathetic

“it’s okay” [pausing] I am frustrated because food makes me lose my shape, and add weight” [hand gestures]

Empathic Response With Directing (Therapeutic): Directs conversation to client’s frustration.

Attending: Behaviors that show one is actively listening.

Silence: A therapeutic listening response. The person asking the questions remains quiet in order to allow for the other person to continue talking

“In the past whenever you are frustrated what do you do?

[little smile]

T: I hope something has worked before

F: worried

“Usually I talk to my parents. They are usually of great help” [exhales]

Encouraging Comparison (Therapeutic): Looking for coping mechanisms that may have worked in the past.

“Have you ever discussed this situation with your parents?”

[continuing to lean forward]

T: I hope she has an open relationship with her parents

F: hopeful

“No, I don’t know what they will think of it! Perhaps I should”

Closed-Ended Question (Therapeutic): May be helpful when needing to elicit specific information.

“Well our time is almost done here I appreciate you talking to me about health issue. I suppose you talk to your parents and they will hopefully understand what you going though. Attentively, you should see a nutritionist to advice on proper eating habits since for a strong body and mind you must feed well.” Can I get you something else before leaving?” [raising eyebrows]

“Thank you for your time.” [smile]

T: I hope she cleared what was on her mind

F: sorry

“ no, thank you”

Termination Phase

Summarizing (Therapeutic): Providing a summary of the client’s words, feeling, and potential plan.

Closed-ended question: May be helpful when needing to elicit specific information.

Acknowledgment: Recognize client


Whatwent well? Record the parts of the interaction that went well.

Thesetting was perfect fresh air and peaceful, the client response waspositive. The therapeutic conversation uncovered what was frustratingthe client and gave a possible solution. The session also allowed forself-reflection on both verbal and non-verbal responses. Finally Ithink both therapeutic and non-therapeutic techniques were put to usewell (Austin, 2009).

Whatcould have been done differently?

Ithink the session would have need more non therapeutic techniques,allowing for advice on the client, questioning her behavior, andallowing for social responses to help ease the mood and attitude ofthe session.

Whathelp do you need that will make it possible for you to improve yourtherapeuticcommunicationskills?

Morepractice is needed, especially in the perfection of therapeuticcommunication skills. This is help instill self-confidence, how torecognize nonverbal clues, how to allowing the client to be incontrol, and being able to provide feedback that allows the client toknow you are listening and have understood (Austin, 2009).


Austin,D. R. (2009).&nbspTherapeuticrecreation: processes and techniques&nbsp(No.Ed. 6).New York: Sagamore Publishing.