Therapeutic and Team Process Recording
Therapeutic Process Recording: RESIDENT
Pre-Interaction (5 points):
Environment Description
The communication took place in a quiet lounge area within the nursing home. The room was designed in pleasant colors, with comfortable chairs and no distractions. There were no other individuals in the room for confidentiality.
Summary of Events Leading to the Therapeutic Conversation
Before the therapeutic conversation, I performed a standard geriatric patient health screening that allows for determining their general health status. The patient had ambivalent feelings about the diagnosis rendered to her and the fact that she could not have frequent family visits. This creates an opportunity for therapy to continue into discussions about the patient’s emotional and psychological concerns.
DOCUMENTATION & ANALYSIS OF EXCHANGE WITH RESIDENT (10 points):
| What I said and did
a) Verbal Communication b) Non-verbal Communication |
What the resident said and did
a) Verbal Communication b) Non-verbal communication |
My feelings & thoughts experienced during the exchange (minimum of 2)
a) Feeling/thought b) Feeling/thought |
Inference of communication Students’s inference of resident communication based on verbal and non-verbal cues i.e. what is behind
communication – happy, scared, angry, etc. |
Analysis of communication
a- Communication technique used b- Therapeutic or Non-Therapeutic c- Alternative statement if Non-Therapeutic
|
| a- “I noticed you seemed a bit down today. Would you like to talk about what’s been on your mind?”
b- Maintained eye contact, leaned forward slightly to show interest and kept an open posture with relaxed hands on my lap. |
a- “Yes, I’ve been feeling quite lonely and worried about my health. I miss my family, and it is hard being here alone.”
b- The patient sighed deeply and looked down at their hands, and their shoulders slumped slightly. |
a- Empathy towards the patient’s loneliness and worry.
b- Concern about how to best provide comfort and support. |
The patient is feeling lonely and anxious about their health and the lack of family visits, which is impacting her emotional well-being. | a- Sharing feelings and concerns openly.
b- Therapeutic, as it encourages openness and trust.
c- Not applicable.
|
| a- “It sounds really tough to be away from your family. Can you tell me more about what you are feeling right now?”
b- Nodded slightly to encourage the patient to continue speaking and maintained a soft, understanding expression |
a- “I just feel so isolated. I worry that I might never get better and see them again.”
b- Tears welled up in the patient’s eyes, and they wrung their hands nervously. |
a- Deep compassion for the patient’s sense of isolation.
b- Determination to help alleviate her worries and provide reassurance. |
The patient is experiencing intense feelings of isolation and fear about her health and future. | a- Expressing deep emotional concerns.
b- Therapeutic, as it allows for emotional release and support.
c- Not applicable.
|
| a- “It’s completely natural to feel this way, given your situation. Let’s explore some ways we can help you feel more connected and supported.”
b- Placed a comforting hand on the patient’s shoulder, maintaining eye contact. |
a- “Thank you, which means a lot. Maybe I could talk to my family more often and join some activities here.”
b- The patient smiled faintly and straightened up slightly. |
a- Encouraged by the patient’s openness to finding solutions.
b- Hopeful about helping the patient feel more connected and less isolated. |
The patient is open to finding ways to improve their situation and values support and connection. | a- Expressing needs and seeking solutions.
b- Therapeutic, as it focuses on finding positive changes.
c- Not applicable.
|
| a- “That’s a great idea! Let’s set up a schedule for regular calls with your family and look into some group activities you might enjoy.”
b- smiled warmly and gave a reassuring nod. |
a- “Thank you for understanding. I think that will really help me feel better.”
b- The patient’s face relaxed, and he nodded in agreement. |
a- Satisfaction from helping the patient find solutions.
b- Confidence in the positive impact of our plans. |
The patient feels understood and optimistic about the proposed solutions. | a- Acceptance and planning for action.
b- Therapeutic, as it reinforces hope and support.
c- Not applicable.
|
SUMMARY & REFLECTION of RESIDENT COMMUNICATION (5 points):
Summary of Major Theme
The key concepts in the communication interchanges with the geriatric patient were loneliness, fear of ill health, and the need for social interaction and support. The emotions manifested by the patient as a result of few family members visiting the nursing home and fear of health are among the psychological challenges that elderly nursing home residents experience. One of the main themes of the conversation is the topic of how to can help the patient cope with these feelings, such as improving the patient’s social connectedness and emotional well-being.
The Geriatric Population Faces Unique Challenges. How Do You Feel Your Patient’s Physical and Psychosocial Challenges Influenced the Communication Exchange?
Physical
The physical health of the patient, including the recent diagnosis, had a great impact on the communication exchange. Physical diseases can lead to helplessness and dependence that might add to feelings of anxiety and fear. These health concerns made the patient more comfortable with admitting their fears and asking for them to be calmed. They would also experience physical limitations that would enhance their sense of isolation and limited social interactions within the nursing home.
Psychosocial
The communication process was hinged on psychosocial challenges such as feelings of loneliness and isolation occasioned by a possible lack of family visits. A lack of social and communication support was also one of the reasons for the patient’s emotional condition, as is typical for patients in elder nursing homes (Brandt et al., 2022). This left the patient emotionally depressed and isolated and was thus ready to accept the explanations of his emotional needs and how to go about solving them. These related mental and emotional problems added to the importance of communication and the importance of addressing mental and emotional health issues.
The Influence of Identified Personal Feelings on the Interaction
My personal feelings, including empathy, compassion, and concern played a significant role during the interaction. Empathy helped me to understand the patient’s feelings and gave the patient the feeling that she was heard and understood. Empathy made me look for ways to reduce the loneliness and anxiety of the patient. My goal was to give the patient the best possible care, so I used reflective listening and gave tangible advice to help the patient feel more connected and at ease. These feelings guaranteed that my communication with the patient was therapeutic and supportive (Moudatsou et al., 2020).
Therapeutic Process Recording: TEAM MEMBER
Pre-Interaction (5 points):
Description of the Environment
This encounter happened during a change of shift in the nursing station of a geriatric unit. The environment was relatively crowded as other healthcare staff were strolling around and talking. A second nurse and a nursing aide were in the same area but were not engaged in the conversation.
A Summary of Events Leading Up to the Therapeutic Conversation
Before the conversation, I had felt that a fellow team member and a nurse was quite agitated and impatient with other staff and patients. Being aware of the effect her expressions had on the patients, I chose to discuss the situation with her and explain that I was willing to help in case of needed intervention. This exchange was designed to help her cope with her stress and develop a team of workers with other members.
DOCUMENTATION & ANALYSIS OF EXCHANGE WITH TEAM MEMBER (10 points):
| What I said and did
a) Verbal Communication b) Non-verbal Communication |
What team members said and did
a) Verbal Communication b) Non-verbal communication |
My feelings & thoughts experienced during the exchange (minimum of 2)
a) Feeling/thought b) Feeling/thought |
Inference of communication Student’s inference of team member’s communication based on verbal and non-verbal cues i.e. what is behind communication – happy, frustrated, angry, etc. | Analysis of communication
a- Communication technique used b- Did communication improve client care/safety? c- Principles of professional communication observed. (see document in assignment module) |
| a- “I noticed you’ve been quite busy and seem stressed today. Is there anything I can help you with or any concerns you want to share?”
b- Maintained eye contact, nodded to show understanding, and used a calm tone of voice. |
a- “Yes, it’s been a hectic day with several critical patients. I’m trying to manage everything, but it’s overwhelming.”
b- Sighed heavily, avoided eye contact initially, but then looked up while speaking, indicating a willingness to engage. |
a- Concerned about her well-being and its impact on patient care.
b- Empathetic, wanting to offer support to alleviate her stress.
|
The team member appeared overwhelmed and frustrated, likely due to the high workload and pressure of managing critical patients. Her non-verbal cues, such as the heavy sigh and initial avoidance of eye contact, suggested a need for support and understanding. | a- Active listening and empathic inquiry.
b- Yes, by addressing the team member’s stress, it helped in creating a supportive environment which is crucial for maintaining high standards of patient care and safety.
c- · Respect and empathy · Active listening · Supportive dialogue |
| a- “Let’s see if we can delegate some tasks. Maybe we can ask the nursing assistant to handle a few non-critical duties.”
b- Smiled reassuringly and placed a hand on her shoulder briefly to show support. |
a- “That would be really helpful. Thank you for understanding.”
b- Smiled back and visibly relaxed her posture. |
a- Relief that my offer of help was accepted.
b- Encouraged that the conversation was positively impacting the team members. |
The team member seemed relieved and grateful, indicating that she felt supported and less isolated in her responsibilities.
|
a- Collaborative problem-solving.
b- Yes, by effectively delegating tasks, it ensured that patient care remained consistent and the team member’s stress was mitigated, which enhances overall patient safety.
c- · Collaboration and teamwork · Problem-solving · Emotional support |
| a- “Let’s take a few minutes to breathe and then create a quick action plan. We can assign specific roles to make things smoother.”
b- Gestured towards a chair, inviting the team member to sit and discuss calmly. |
a- “Thank you. That sounds like a good idea. I could really use a moment to regroup.”
b- Took a deep breath and sat down, showing readiness to engage in planning. |
a- Calm and focused on finding a structured solution.
b- Encouraged by the team member’s willingness to collaborate. |
The team member felt overwhelmed but showed readiness to cooperate, indicating a need for structured support and reassurance. | a- Calm guidance and structured planning.
b- Yes, it helped to create a clear plan of action, which is crucial for maintaining patient safety and care quality.
c- · Calm and composed guidance · Structured problem-solving · Reassurance and support
|
| a- “We’re a team, and it’s important we support each other. If you ever feel like this again, please don’t hesitate to speak up.”
b- Placed a hand on the team member’s arm briefly to convey solidarity and support. |
a- “I will. It helps to know that I can rely on my colleagues. Thanks for understanding.”
b- Smiled appreciatively and stood a bit straighter, showing relief and gratitude. |
a- Satisfied that the team member felt supported and understood.
b- Optimistic about improving team dynamics and communication in the future. |
The team member felt reassured and supported, indicating a positive shift in morale and team cohesion. | a- Supportive affirmation and reassurance.
b- Yes, fostering a supportive team environment enhances overall team functionality and patient care quality.
c- · Affirmation and support · Team cohesion · Empathy and reassurance |
Description of the Environment
SUMMARY & REFLECTION of RESIDENT COMMUNICATION (5 points):
The Goal of the Communication Exchange
Yes, the objective of the communication exchange was achieved. The team member stated her concerns and agreed to receive the provided support, which resulted in more manageable workloads and reduced stress. This enabled them to have a more positive working environment and improve the quality of patient care.
Influence of Personal Feelings and Past Experiences on Communication Exchange
My sympathy and compassion resulting from previous experiences of anxiety in demanding circumstances contributed positively to the interaction. These feelings enabled me to offer support and even actively listen to my fellow team members, leading to the effective management of the stress they experienced. My awareness of the stress associated with the working environment of healthcare professionals helped me start the conversation gently and calmly.
Strategies to Improve Verbal and Non-Verbal Communication Prior to Moving Forward into ADNG 2100 Clinical II
Verbal Strategy
I will incorporate precise self-statements and performance-related feedback during interactions to reduce ambiguity and reinforce desired behavioral elements. This comprises paraphrasing and summarizing what the other person says to show that one has understood and, as such, offering feedback on how to improve.
Non-Verbal Strategy
Non-verbal communication will draw my attention to body language, facial expressions, and gestures that can convey “attentiveness and empathy” (Abdulghafor et al., 2022). This entails maintaining eye contact, having an open-body posture, and reflecting on the other person’s emotions to develop trust.
References
Abdulghafor, R., Turaev, S., & Ali, M. A. H. (2022). Body language analysis in healthcare: An overview. Healthcare, 10(7), 1251. https://doi.org/10.3390/healthcare10071251
Brandt, L., Liu, S., Heim, C., & Heinz, A. (2022). The effects of social isolation stress and discrimination on mental health. Translational Psychiatry, 12(1), 1–11. https://doi.org/10.1038/s41398-022-02178-4
Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The role of empathy in health and social care professionals. Healthcare, 8(1), 1–9. https://doi.org/10.3390/
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Question 
Therapeutic and Team Process Recording Instructions* (40 points-Human Flourishing-outcome assignment)
Objectives:
1) Analyze communication with residents and team members in a clinical setting to identify communication patterns
Therapeutic and Team Process Recording
2) Utilize analysis to identify strengths and areas for improvement of therapeutic and professional communication
3) Develop skills in the identification of therapeutic communication techniques
4) Introduce awareness of the impact of thoughts/feelings on communication
5) Introduce the ability to make accurate inferences based on both verbal and nonverbal communication
Guidelines for Documentation and Analysis of Communication
What I said and did
a) Verbal Communication
b) Non-verbal Communication What resident/team member say and did
a) Verbal Communication
b) Non-Verbal Communication My feelings & thoughts experienced during the exchange (minimum of 2)
a) Feeling/thought
b) Feeling/thought Inference of communication Student’s inference of resident/team member communication based on verbal and non-verbal communication i.e. what is behind communication – happy, scared, angry, etc. Analysis of resident communication
a- Communication technique used
b- Therapeutic or Non-Therapeutic
c- Alternative statement if Non-Therapeutic
Analysis of team member communication
a- Communication technique used
b- Did communication improve client care/safety?
c- Principles of professional communication observed. (see document in assignment module)
Document a segment of salient exchanges with a resident/team member where you reached, or attempted to reach, a feeling level (where therapeutic communication occurs). The segment needs to include a minimum of four exchanges.
DO NOT include your introduction to the resident/team member as it is assumed rapport has been established. Record your statements/questions verbatim. Include non-verbal communication. Record your resident’s/team member’s responses (verbal AND non-verbal). If the resident/team member shares a long exchange, you may summarize the story but MUST include the last thing the client said verbatim. E.g. “Oh, I had a lot of jobs back then” (at this point resident shares stories of several different jobs over a 10 year period).
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