Psychology: Roadblocks to Therapeutic Communication

Roadblocks to Therapeutic Communication Part II – The Patient's Behavior

• Projection: when a patient attributes their own feelings to someone else, e.g., accusing a healthcare provider (HCP) of anger when they themselves are angry.
• Rationalization: when a patient justifies unacceptable behavior with false reasoning, e.g., blaming an HCP for not asking about availability when they failed to show up for an appointment.
• Regression: when a patient reverts to childish or immature behaviors or thoughts in difficult situations.
• Repression: when a patient suppresses painful or difficult thoughts, feelings, or ideas, e.g., avoiding decision-making or consideration of unpleasant options.

Angry Patients

• Anger can stem from perceived inadequate care, unfair treatment, loss of control, frustration, or ineffective therapeutic communication.
• Identify anger by recognizing physical and verbal cues.
• Manage anger by:
  • Staying calm, respectful, and genuine.
  • Focusing on the patient's physical and medical needs.
  • Avoiding defensive responses to accusations.
  • Encouraging patients to specify their concerns and underlying reasons.
  • Presenting a clear and firm perspective.
  • Following through on promises.
  • Providing a safe space for patients to express emotions.

Anxious Patients

• Anxiety can arise from the medical environment, uncertainty about illness, or fear of test results.
• Recognize anxiety by observing physical and verbal cues.
• Manage anxiety by:
  • Quickly identifying signs of anxiety.
  • Acknowledging anxiety and its sources.
  • Using nonverbal communication, maintaining distance, and making eye contact.
  • Listening attentively and empathetically.
  • Determining support systems, such as family and friends.
  • Creating a warm and trustworthy environment.
  • Providing truthful information about anxiety sources.

Communication with Other Members of the Healthcare Team – Colleagues

• Choose appropriate times and places for important communication.
• Respect coworkers' time by asking about availability before discussing important matters.

Communication with Other Members of the Healthcare Team – Supervisor

• Keep supervisors informed about patient care concerns, problems, or office issues.
• Ask questions when unsure about procedures or responsibilities.
• Minimize interruptions of supervisors' time by scheduling discussions or saving questions.
• Show initiative by being proactive and open-eyed at work.