Which comments by a nurse demonstrate the use of therapeutic communication techniques? (Select all that apply)

Choice A reason: Asking if the client felt this way before hospitalization focuses on past feelings, which may not address the current emotional state or therapeutic needs. While it gathers history, it lacks empathy and does not encourage the client to elaborate on their current concerns, making it less therapeutic.

Choice B reason: Reflecting the client’s statement by asking if they feel the setting is wrong demonstrates active listening and empathy, key components of therapeutic communication. It encourages the client to express feelings, fostering trust and exploration of their concerns, aligning with psychiatric nursing principles, making this the correct choice.

Choice C reason: Suggesting the client discuss concerns later with a doctor dismisses their current emotional state, potentially undermining trust in the nurse-client relationship. It avoids immediate engagement and fails to address the client’s feelings, which is critical in psychiatric care, making this response non-therapeutic and incorrect.

Choice D reason: Labeling the client’s statement as inappropriate is judgmental and dismissive, hindering therapeutic communication. It may increase the client’s sense of alienation or shame, contrary to psychiatric nursing goals of building trust and validating feelings. This response is non-therapeutic and does not support the client’s emotional needs.

Choice A reason: Transference occurs when a patient unconsciously projects feelings or attitudes from past relationships onto the nurse, a common phenomenon in psychotherapy. This influences the therapeutic relationship, requiring careful management, aligning with psychoanalytic principles, making this the correct choice.

Choice B reason: The nurse projecting feelings onto the patient describes countertransference, not transference. This involves the nurse’s unconscious biases, which can hinder therapy if not addressed, but it is distinct from the patient-driven process of transference, making this choice incorrect.

Choice C reason: A patient refusing to engage reflects resistance, not transference. Resistance involves avoiding therapeutic work, often due to anxiety, but it lacks the projective quality of transference, which involves redirecting past emotions, making this choice incorrect.

Choice D reason: Establishing boundaries is a therapeutic technique, not transference. Boundaries ensure professional interactions but do not involve the unconscious projection of feelings from past relationships, which defines transference, making this choice incorrect for the described phenomenon.