The Helping/Therapeutic Relationship

Phases of the Therapeutic Relationship

Concepts of Caring

Ways of Knowing

Bridges/Barriers

Bridges

Barriers

Phase 2 - Orientation Phase:
The phase in which the purpose, roles and rules of the process of the relationship are defined.

Phase 3 - Working Phase:
The problem-solving phase that parallels the prior planning with implementation of phases of the nursing process.

Phase 1 - Preinteraction:
The phase in which the nurse develops an appropriate physical and interpersonal environment for an optimal relationship.

Phase 4 - Termination Phase:
The phase in which the nurse is discharged from the client. Goals and achievements must be discussed, along with the clients’ feelings and future goals.

Swanson (5 Categories of Caring)

Roach (Concepts of Caring)

Personal Knowledge
Knowledge derived from the depth and power of the interpersonal relationship with the patient.

Ethics
(The Moral Component): Knowledge that emerges from ethical dilemmas.

Esthetics
(The Art of Nursing); Creativity, with an artistic or expressive component. Explores intangible, deeper meanings & connections.

Emancipatory Knowledge
Knowledge that allows change to occur and represents the ability to recognize social and political problems of injustice or inequity.


*Added by Chinn and Kramer in 2008

Empirics
(The Science of Nursing); Knowledge that is systematically organized into general laws and theories.

"Doing For" Assisting the client with actions he/ she can’t do themselves

Enabling Facilitating the other person’s passage through life transitions

"Being With" Being emotionally present for the client

"Maintaining Belief" Sustaining faith in the client’s capacity to face life events

Knowing Understanding the client’s life event

Competence Having the skills, knowledge, energy and motivation required to respond to the demands of one’s responsibilities

Confidence The quality that fosters trusting relationships and builds mutual respect

Compassion Feeling sensitivity to the pain of others

Conscience A state of moral awareness

Commitment Deliberately acting in accordance with the convergence between one’s desires and one’s obligations

Watson (9 Carative Processes)


  1. Humanistic-altruistic values


  2. Instilling or enabling faith and help


  3. Cultivating sensitivity to oneself and others


  4. Developing a helping-trusting, human caring relationship


  5. Promoting and accepting expression of positive and negative feelings


  6. Systematic use of scientific problem-solving process


  7. Providing for a supportive, protective, or corrective


    mental, social, spiritual environment


  8. Assisting with gratification of human needs


  9. Allowing for existential-phenomenological dimensions

Empathy
The ability to perceive accurately another person’s feelings and to convey meaning to the client

Mutuality
Shared agreement by the client and nurse regarding the client’s health problems and the means for resolving them

Trust and Veracity
Building emotional reliance on the consistency and continuity of experience

Confidentiality
Protecting the client’s sensitive and private information at all costs

Caring and Respect
Commitment that involves respect and concern for the unique humanity of every client

Ethical Behaviour
Acting based on moral awareness of right and wrong

Stereotyping
Attributing characteristics to a group of people as though all persons in the identified group possessed them

Space Violation
Overstepping a client’s boundaries by invading his/ her personal space

Anxiety
Having a vague, persistent feeling of impending doom on an unreasonable level.

Confidentiality Violation
Disclosing of any sensitive and private information about the client without the client’s consent or knowledge