Clinical meaning
Advanced therapeutic communication builds on foundational skills by incorporating motivational interviewing, crisis intervention communication, and trauma-informed approaches. Motivational interviewing uses open-ended questions, affirmations, reflective listening, and summarizing (OARS) to explore ambivalence and support behavior change. Transference occurs when a patient projects feelings from past relationships onto the nurse, while countertransference occurs when the nurse unconsciously redirects feelings toward the patient. Recognizing these dynamics is essential for maintaining objectivity and therapeutic effectiveness. Interprofessional communication frameworks such as SBAR (Situation, Background, Assessment, Recommendation) standardize handoff communication and reduce the risk of errors during care transitions.
Exam relevance
Risk factors: - Unrecognized countertransference affecting clinical judgment - Boundary crossing escalating into boundary violations - Implicit bias influencing communication with diverse populations - Failure to use qualified interpreters for patients with language barriers - Inadequate de-escalation skills leading to patient or staff harm - Using family members as interpreters which compromises accuracy and confidentiality