Therapeutic communication is a clinical skill with a sequence, not a personality trait: set the stage, respond, close. Work through six patients across the lifespan — choose the environment and presence moves first, then the one sentence you actually say, then how you end it. Every choice is graded with the reason it opens or closes the conversation.
Choose a patient
1 · Set the stage
Select every move you would make before and during this encounter. Some choices shut the patient down.
2 · Say one thing
The patient has just spoken. Choose your response.
3 · Close the encounter
Peplau’s termination phase: summarize, confirm understanding, say what happens next and who is coming after you.
At the bedside
Set the stage first — then the patient speaks.
Rapport 0 / 0
The moves, named
Therapeutic: open-ended question, silence (count to five — patients disclose in the gap), reflection, restating, clarification, focusing, offering self, making an observation, summarizing.
Non-therapeutic: false reassurance, “why” questions, giving advice, changing the subject, approval or disapproval, defensiveness, stereotyped comfort.
SOLER: Sit squarely, Open posture, Lean forward, Eye contact appropriate to culture, Relaxed.
Before you conclude anything psychological: hearing aids in and on, glasses on, dentures in, room quiet, pain treated, head of bed up.