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Therapeutic Communication

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Therapeutic Communication

Overview: While sitting in the milieu, I had a conversation with patient “M”, a schizophrenic with severe depression. She is sitting silently across the table from me, listening to another patient talk. Her face looks emotionless, almost distant. She is dressed well, with a full face of make up, and her is done up.

D: Hi, “M”, what’s on the agenda for you today?
E: Since she was not talking to anyone, I thought this would be a neutral enough opening statement to start a conversation.
A: “Oh, not much, getting ready to go home tomorrow. I have to clean out my fridge when I get there; it’s full of rotting food”.
B: She’s thinking about what she left behind when she left her home to come to Bayridge. It sounds like her admission here was not necessarily planned nor did she have time to prepare her home for her departure.
C: I’m excited for her to be going home, especially since I know this patient’s history from reading her chart, she’s been in for over three weeks. She left her life rather suddenly because of her severe instability, so it is good to know that she and her doctors feel like she is stable enough to go home.
D: “That’s exciting you get to go home! Do you feel ready?”
E: I’m acknowledging her news with my own feelings for her, and asking her if she feels ready, considering it is a big step in her recovery. It was a close ended question.
A: “I am ready. I’m ready to get out of here. I just hope I don’t have to come back. This is my thirteenth visit in the past two years; I don’t want to come back.”
B: Her statement means exactly what she said, she does not want to return.
C: She sounds fed up with being a patient here, and does not want to return, but I hear doubt in her voice with her statement about being admitted here 13 prior times
D: “Yeah, I don’t blame you. It must be hard to leave your other life so often,…...

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