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Evidence-Based Practice: Therapeutic Communication

The place of communication in life cannot be overemphasized. Whether verbal or non-verbal, it is needed for transmission and exchange of knowledge, information, and meanings among people. It is a universal concept in contexts such as families, relationships, and organizations just to mention but a few.  Communication is as important in nursing practice as it is in other spheres of life. Besides scientific knowledge, nursing practice calls for effective communication among workers and between workers and their clients.  Indeed, Kourkouta and Papathanasiou (2014: p.65) agree that “communication is a vital element in nursing in all areas of activity and in all its interventions such as prevention, treatment, therapy, rehabilitation, education, and health promotion”. The role of communication is particularly elevated in the context of the nurse-patient relationship where the nurse is obliged to help the client/patient as much as possible through mutual respect and trust and being sensitive to the needs of the patient. This relationship, the therapeutic relationship, is very important because it has the potential to shape or determine patient outcomes. This paper discusses the therapeutic techniques observed in Cable News Network (CNN) interview in which Anderson Cooper interviews Melanie Trump in relation to various issues surrounding Donald Trump and the 2016 US Presidential Election.

Interview Summary/Topic

CNN’s Anderson Cooper interviews Melanie Trump, the US first lady, about various issues surrounding Donald Trump’s candidacy in the 2016 US Presidential Election. Cooper starts by asking Melanie about the sexual abuse allegations that had been made against Donald Trump. She dismisses the allegations as untrue and terms them pure propaganda that was being peddled by the media.  She also addresses the issue of controversial photos that had been posted with an apparent intention to taint her image. She says she is proud for having taken the pictures many years ago when she was a model. She is also asked about her son who she says she advises accordingly on what to say and how to conduct himself during the campaign. She terms her marriage strong, saying Trump calls her a “rock for the whole family” (6:08). She agrees with Trump on his stand on various issues like security, jobs, and the economy. She defends her husband’s position and praises him, saying he has the welfare of America in his heart, and that he means the best for the country. She praises him as kind and says all the bad things being said about him are sponsored by the opposition and are merely meant to damage his reputation ahead of the election. She talks of her decision not to be on social media because of the negativity associated with it. She says Trump is free to communicate through platforms like Tweeter.

Therapeutic Techniques

Several therapeutic techniques can be observed in the interview. Some of them are discussed below.

Active Listening

Simply defined, active listening means remaining attentive to what one’s partner in communication is saying, be it verbally or non-verbally. In the interview, Cooper practices this technique, as every time he asks Melanie a question, he gives her time to answer it exhaustively. This technique is evidenced by acts such as sitting while facing the client, leaning towards the client, and maintaining eye contact. Importantly, it should be noted that listening here goes means more than giving one an ear or time to speak. While these aspects are part of listening, active listening extends to include remaining keen enough as to look out for any non-verbal cues. Cooper practices active listening throughout the interview. His changing facial expressions indicate that he is keen, attentive, and careful not to miss out anything that Melanie says whether verbally or non-verbally. At 1:10, he is observed to slightly lean forward towards Melanie as he poses his question after which he moves back (at 1:11) and relaxes in his seat as he listens to her response.

Sharing Empathy

Finset and Knut (2017) offer a definition of empathy as “the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experiences of another” (p.65). Therefore, the sharing of empathy would mean understanding and accepting another person’s reality by accurately perceiving their feelings. Effectively communicating such understanding is equally elevated in this regard. In the interview, Cooper refers to the campaign and lets Melanie know he knows it has been hard for the Trumps. He asks, “Has this whole campaign been harder than you expected?” (CNN, 2016; 1:48).  He goes on “I know you said you came into this with your eyes open…has it…yeah…has it been tougher than you expected?” (1:49-1:56). By asking this, Cooper makes it clear that he understands how tough the campaign has been for Melanie and even as the interview goes on, he makes it known that he is alive to that fact.

This technique gains elevation in the therapeutic relationship because through it, nurses can put themselves in the shoes of their clients, thereby visualizing and feeling their experiences from a shared perspective. In such a relationship, empathy “is a fundamental attitude for the physical and mental well-being of both people “(Terezam et al., 2017: p. 669). Here, the significance of empathy emerges as not just limited to the patient but also the healthcare professional. It is associated with many positive outcomes in the therapeutic relationship, for instance increased patient satisfaction as well as compliance with prescribed or recommended medication/treatment (Duarte et al., 2016).

Movement Synchrony

Evidence suggests that in interpersonal interactions, individuals “tend to adjust to one another’s posture and movements in an intricate dance of mirrored movements” (Finset & Knut, 2017; p. 67). When this happens, it facilitates mutual positivity and smoothness in the interaction, even promoting a sense of affiliation. Additionally, it is highly likely that there will be more positive emotions in an interaction where there is movement synchrony. In the interview under focus, interactive alignment is noted in terms of the body movements of Cooper and Melanie. For instance, from 3:03-3:06, the Cooper’s right-hand movements are in synch with those of Melanie’s left hand.  Interestingly, it turns out that Melanie agrees with Cooper on his remark that “…it was much earlier than you had actually expected” (3:05), to which she expresses her agreement by answering, “Correct” (3:06).  As already implied, this kind of mimicry represents a form of reciprocal nonverbal communication that facilitates mutual positivity in a therapeutic relationship. By and large, it may not be voluntary, but it speaks to the existence of flow in the on-going communication, that is, the exchange and sharing of information and meanings.

Sharing Observations

This concerns making observations about something that concerns the other person. In 1:11, Cooper’s reference to a letter that Melanie’s lawyer had sent implies he is aware of the things affecting her in one way or another; he does not hesitate to point them out. In a therapeutic relationship, the nurse, by making and sharing observations about the client communicates her closeness and concern for the client. For instance, the client may be looking very neat; it does well for the relationship if the nurse takes note of this and shares his/her observation. This may facilitate the sharing of information in a more open manner, hence subsequently better outcomes for both the client and the nurse.

Sharing Hope

This means the act of communicating to the client a sense of possibility and a chance for better things.  It may also entail offering encouragement as well as positive feedback when it is appropriate. In the interview, Cooper communicates this sense of better things and offers Melanie an opportunity to comment on what she hopes to do when she gets to the White House. At 9:07-9:09, Cooper reminds her of “…what you will hope to do when you get to the White House”. By talking like this, Cooper enables her to visualize about her life in the White House, arguably giving her hope and a sense of possibility that after all, Trump is going to win the election. The sharing of hope gains elevation in therapeutic relationships because it fills the client with optimism; that things will be better.

Conclusion

In a word, therapeutic techniques are of great significance in the context of therapeutic relationships because in many ways they lead to better outcomes for both the nurse and the client. In the CNN interview discussed, some of the techniques observed include active listening, sharing empathy, sharing hope, sharing observations, and movement synchrony.  They ought to be incorporated into the therapeutic relationship since they can help achieve the therapeutic effect more easily. They represent a very important form of communication defined by mutual cooperation, understanding, support, compassion, and feeling.