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“The combination of knowledgeable discussion and richly illustrated case f N
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examples makes this an innovative text and an essential resource for rsin
those who are challenged with delivering mental health care. A must g, C
read for all students.” hia
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Allison Tennant, Nurse Consultant and Psychotherapist, gm
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Rampton Hospital, UK i U
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“This useful book focuses on the skills that are absolutely central and e
essential to all mental health nursing, from basic communication skills rsity
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to specific interventions and approaches.” .6
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Dr Neil Brimblecombe, Director of Nursing/Chief Operating Officer, 5
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South Staffordshire & Shropshire Healthcare NHS Foundation Trust .11
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This practical book provides a comprehensive guide to communication t [07
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in mental health nursing, with an emphasis on demonstrating the use 8/1
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of different skills in various clinical settings. Written by experienced ]. C
mental health professionals, the book is richly illustrated with a range op
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of clinical case examples that will be recognisable to all nurses. rig
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Centred on the communication process as a whole, the topics are M
carefully presented through the use of patient-nurse dialogues and cG
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exchanges which bring the subject to life. This will help you to: w
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• Develop essential communication skills lo
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• Communicate confidently l E
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• Use phatic communication effectively uc
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• Use self-reflection in your practice Jean Morrissey and Patrick Callaghan n H
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• Develop the ability to deal with conflict ld
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• Develop empathic helping relationships s, L
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• Draw upon various therapeutic models of communication C
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JeAN MORRiSSey is Lecturer in Mental Health Nursing at the School t to
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of Nursing and Midwifery Studies, Trinity College Dublin, Ireland. e re
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PDAirTeRctioCrK o Cf RAelsleAagrHchA Na ti sth Per oSfcehsosoolr ooff NMuersnitnagl ,H Meiadlwthi fNeruyr sainndg and PaJea istributed
Physiotherapy, University of Nottingham, UK. trickn Mo or mod
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Cover Design: H allaghanissey and d in any way withou
andsDesign.ca t permission.
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“Learningtocommunicateeffectivelyisvitalforallnurses... Thisexcitingnewbook, u
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withanaccessibleandengagingstyle,providesnursesworkinginmentalhealth,with o
avaluableandcomprehensiveintroductiontosuccessfulcommunication.” f N
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MartinaMcGuinness,NursePracticeDevelopmentCo-ordinator, rsin
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HSEDublin,Ireland , C
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“Thecombinationofknowledgeablediscussionandrichlyillustratedcaseexamples m
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makesthisaninnovativetextandanessentialresourceforthosewhoarechallenged i U
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withdeliveringmentalhealthcare.Amustreadforallstudents.” iv
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AllisonTennant,NurseConsultantandPsychotherapist, rsity
RamptonHospital,UK 5.6
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“Thisusefulbookfocusesontheskillsthatareabsolutelycentralandessentialtoall 8.1
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mentalhealthnursing,frombasiccommunicationskillstospecificinterventionsand 7] a
approaches. The layout is practical with detailed practical examples and questions t [0
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to ensure understanding... A book that will be of use to, both, students and more /1
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experiencedstaffwhowishtodeveloporrefreshparticularskills.” /1
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DrNeilBrimblecombe,DirectorofNursing/ChiefOperatingOfficer, ]. C
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“This is a fantastic book, absolutely packed with just about everything a mental t ©
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healthnurseneedstoknowaboutcommunicationskills.Iinstantlywantedtohand c
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out copies to our students. The succinctly written chapters cover a wide range of ra
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key communications skills and each provides clear explanations, examples from -H
‘everyday’lifeandclinicalpractice,withopportunitiestoreflectonyourownexperi- ill G
ences.Thereisplentyofusefulmaterialtohelpanymentalhealthpractitionerwork lob
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moreeffectivelywithserviceusersandcolleagues.Highlyrecommended.” l E
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AlanSimpson,ProfessorofCollaborativeMentalHealthNursing, uc
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CityUniversityLondon,UK tio
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Patrick Callaghan op
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email:[email protected] rsity
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Firstpublished2011 t [0
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Copyright©JeanMorrisseyandPatrickCallaghan2011 /1
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Allrightsreserved.Exceptforthequotationofshortpassagesforthepurposesof p
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criticismandreview,nopartofthispublicationmaybereproduced,storedina rig
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retrievalsystem,ortransmitted,inanyformorbyanymeans,electronic, t ©
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mechanical,photocopying,recordingorotherwise,withoutthepriorwritten c
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permissionofthepublisheroralicencefromtheCopyrightLicensingAgency ra
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Limited.Detailsofsuchlicences(forreprographicreproduction)maybeobtained -H
fromtheCopyrightLicensingAgencyLtdofSaffronHouse,6–10KirbyStreet, ill G
LondonEC1N8TS. lob
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AcataloguerecordofthisbookisavailablefromtheBritishLibrary uc
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ISBN-13:978-0-33-523870-5(pb)978-0-33-523871-2(hb) H
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ISBN-10:033523870X(pb)0335238718(hb) ldin
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e-ISBN:9780335238729 s, L
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LibraryofCongressCataloging-in-PublicationData . N
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TypesetbyAptaraInc.,India red
PrintedintheUKbyBellandBainLtd,Glasgow istrib
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Fictitiousnamesofcompanies,products,people,charactersand/ordatathatmay o
beusedherein(incasestudiesorinexamples)arenotintendedtorepresentany r mo
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Contents cu
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Abouttheauthors ix niv
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Acknowledgements xi rsity
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Preface xiii .1
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1 Core communication skills in mental ] at [0
health nursing 1 7
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Introduction 1 8/1
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Learningoutcomes 1 ]. C
Interpersonalskills 1 op
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Usingskillsinpractice 13 rig
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Conclusion 14 t ©
Reflectivequestions 15 M
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2 Values, culture and evidence-based -H
communication 16 ill G
Introduction 16 lob
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Learningoutcomes 16 l E
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Values-basedcommunication 16 uc
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Culture-basedcommunication 18 tio
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Evidence-basedcommunication 21 Ho
Skillsforevidence-basedpractice 22 ldin
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Therapeuticcommunication:whatworks,forwhomandunder s, L
whatconditions? 22 LC
Fosteringrecoveryandwellbeingthroughtherapeutic . N
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communication 27 t to
Conclusion 29 be
Reflectivequestions 29 red
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3 Reflection and communication 30 te
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Introduction 30 or m
Learningoutcomes 30 od
Understandingreflection–whatisit? 30 ifie
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Thereflectiveprocess 33 in
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Modelsofreflection 33 ny
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Fosteringreflectionandreflectivepractice 37 a
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Theroleofthereflectivefacilitator 42 w
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Organizationalfactorsandreflection 42 cu
Learningtobecomeareflectivepractitioner 43 lty o
Conclusion 44 f N
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Reflectivequestions 45 rsin
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4 The therapeutic use of small talk: ia
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phatic communication 46 m
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Introduction 46 i U
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Learningoutcomes 46 ive
Phaticcommunication 47 rsity
Usingphaticcommunicationinmentalhealthnursing 47 5.6
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Brief,ordinaryandeffective(BOE)communication 50 .1
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Therapeuticuseofself 54 8.1
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Theefficacyandeffectivenessofsmalltalk 59 7] a
Conclusion 59 t [0
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Reflectivequestions 60 /1
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5 Heron’s communication framework: ]. C
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Six Category Intervention Analysis 61 y
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Introduction 61 ht ©
Learningoutcomes 61 M
TheSixCategoryInterventionAnalysis 62 cG
ApplyingSixCategoryInterventionAnalysis 67 raw
DLeeagrenninergatteouusseeothfeinstiexrvceantetgioonrises 7702 -Hill G
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Conclusion 74 ba
Reflectivequestions 75 l Ed
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6 Communicating across cultures 76 n H
Learningoutcomes 76 old
Understandingculture 76 ing
Cultureandmentalhealth 78 s, L
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Cultureandmentalhealthnursing 79 C. N
Communicatingacrosscultures 81 o
Workingwithinterpreters 81 t to b
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Learningtobeculturallycompetentandcapable 87 re
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CReoflneccltuisvieonquestions 8888 istribu
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7 Professional helping relationships 89 r m
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ILnetarrondinucgtoiountcomes 8899 dified in
Patient-centredcare–whatisit? 89 a
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Understandingempathy 92 y w
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Modelsofempathy 94 y w
Empathyorsympathy? 95 ith
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Theuseofempathyinpractice 96 cu
Learningtheskillofempathy 98 lty o
Congruence 99 f N
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Unconditionalpositiveregard 100 rsin
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Settingandmaintainingboundaries 101 , C
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Attributesofeffectivehelpers 105 ia
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Conclusion 106 gm
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Reflectivequestions 106 i U
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8 CInotrmodmucutinonicating assertively 110077 rsity 5
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Learningoutcomes 107 2
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Understandingassertiveness 107 58
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Thebenefitsofbeingassertiveinpractice 112 17
FUascintogrsastshearttiavfefnecetssnsukrislelss’inlevperlacotficaessertiveness 111124 ] at [07
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Assertiveresponses 117 8/1
Learningtouseassertivenessskills 119 6]. C
Conclusion 120 op
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Reflectivequestions 120 rig
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9 Resolving conflict 121 M
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Introduction 121 G
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Learningoutcomes 121 w
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TThypeensaotfucreo,nsfloiucrtces,causesandconsequencesofconflict 112212 ill Glo
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Sourcesofconflict 122 al E
Consequencesofconflict 123 d
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Conflictresolution 124 atio
Conclusion 136 n H
Reflectivequestions 136 old
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10 Solution-focused interventions in mental s, L
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health nursing 137 C
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Introduction 137 o
Learningoutcomes 137 t to b
Solution-focusedinterventions 137 e re
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Thberieefffitchaecryapanydeffectivenessofsolution-focused 140 istribu
Theefficacyandeffectivenessofcognitivebehavioural ted
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approaches 141 r m
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Usingcognitivebehaviouralapproachesinmental d
healthnursing 143 ified
Problem-solvinginterventions(PSI) 147 in a
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TheefficacyandeffectivenessofPSI 147 y w
Conclusion 148 ay
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Reflectivequestions 149 ith
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11 Motivational interviewing in mental health cu
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nursing practice 150 o
Introduction 150 f Nu
Learningoutcomes 150 rsin
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Whatismotivationalinterviewing? 150 , C
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Self-motivationalstatements 151 ia
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ApplyingthethreephasesofMIinmentalhealthnursing 154 m
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ApplyingMItheorytocommunicatingusingMI 155 i U
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Evidence-basedMI 160 iv
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Conclusion 161 rsity
Reflectivequestions 161 5.6
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References 163 1
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Index 173 t [0
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