Therapeutic Communication Examples
Therapeutic conversation, sometimes called therapeutic narrative, is the dialogue that happens in a therapist's office. Its intent is to heal the client, and in this way it differs from social conversation, or the normal, day-to-day conversations in which we engage. Therapeutic conversation is at the heart of a good therapeutic alliance and the key to successful psychotherapy.
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Therapeutic Conversation And Social Conversation: Key Differences
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Therapeutic conversation and good social conversation both center around active listening. In therapeutic conversation, though, if active listening is not present, this is a breach of ethics, rather than a rude conversation partner. In therapeutic conversation, interrupting is more acceptable than in social conversation. In social conversation, interrupting is frowned upon, whereas in therapeutic conversation, interrupting is used to balance the dialogue, especially when there is more than one client present, in order to keep one person from dominating the conversation. Another difference centers around asking questions, and general interest in participants. In therapeutic conversation, the majority of questioning is done by the therapist. Self-disclosure by the therapist is kept to a minimum in order for the client to remain at the center of the conversation. Similarly, the therapist will continue to question the client, providing confrontation, in order to receive answers to questions. Glossing over uncomfortable topics is a hallmark of social conversation. In therapeutic conversation, caring confrontation is the norm.
Example of a Therapeutic Conversation Expressing Empathy
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Client: I can't believe the terrible job I did on that project.
Clinician: You seem too feel a deep sense of shame about your project.
Client: Yes, I do feel ashamed. I just always screw things up.
Clinician: You're sounding really frustrated with yourself.
Client: Yes, I am. I mean, it's not just at my job. I screwed up my relationship with my son. I screwed up my exercise program by stopping only two weeks into it.
Clinician: You're blaming yourself for all those things. Help me understand that better. I wonder if you ever feel like you screwed things up in our work together.
Client: Yes, I did. Remember when I called you at home when my sister had hurt herself again and was admitted to the hospital? I was so upset and really felt like I needed to talk to you even though it was not a scheduled appointment.
Clinician: Sounds like you felt like that wasn't okay with me. I wonder how you thought I reacted to the call?
Client: Well, you didn't sound annoyed. I remember you tried to help me. Still, I felt I had done a stupid thing.
Example of a Similar Conversation, Expressing Sympathy
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In this example, instead of the therapeutic skill of empathy, the "clinician" expresses sympathy, which further entrenches the client in a downward spiral of bad feelings. This example is given to show the importance of empathy in the therapeutic alliance.
Client: I can't believe the terrible job I did on that project.
Clinician: I'm sorry you did so poorly.
Client: Yes, I am too. I guess I just don't have a good work ethic. I should just accept that this job is above me.
Clinician: That's really a shame.
Client: Yes, I really needed this higher salary. My wife and kids are kind of depending on me.
Clinician: How unfortunate that you might let them down like that.
Empathy is an essential part of the therapeutic conversation. Sympathy, on the other hand, is not.
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