Therapeutic Communication in Mental Health Nursing

Book excerpt: Awarded first place in the 2017 AJN Book of the Year Awards in Psychiatric and Mental Health Nursing. This book introduces an innovative technique for therapeutic communication in mental health nursing, expanding the toolkit for nurses seeking to engage challenging patients who have not responded to more conventional therapeutic methods. Linking nursing communication to current research on metaphor and figuration, it is illustrated with accessible clinical examples. Metaphor is a key component of talk-based psychotherapies. But many of the patients whom nurses encounter in the inpatient setting are not good candidates for talk-based approaches, at least initially, because they are violent, withdrawn, highly regressed, or otherwise lacking a vocabulary to convey thoughts and feelings. This book offers specific clinical examples of an approach called the "gestural bridge." This is a method for structuring games and physical activities which connect metaphorically to a patient’s personal themes, activating narrative and observational agency and enabling an exchange of meaning to begin at a time when conventional language is not available. Rooted in what nursing theorists have called the "embodied" or "aesthetic" way of knowing, this approach is both specific and easily grasped. Drawing from contemporary work in literary theory, semiotics, metaphor theory, cognitive science, philosophy, linguistics, psychoanalysis, and the arts, Therapeutic Communication in Mental Health Nursing is important reading for advanced-level practitioners, students, and researchers interested in communication and relationship-building in nursing.