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I chose this topic because it is a foundational skill and knowledge that can be applied to all sectors of nursing. I applied it specifically to mental health because it is typical for patients in a mental health setting to be guarded and at times combative with their behaviour. Applying effective therapeutic communication skills is essential for compassionate and patient-centered care.

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I chose this topic because I believe that maternal health outcomes are a topic that is typically neglected in larger health conversations. I have found during placement that the social determinants of health aren't addressed as much as they should be, and a lot of education isn't provided to the patients. I find that I want to educate myself more on these topics so that I can be a better care provider.

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I chose this topic because I also feel that these topics aren't covered much in a care setting. A lot of the patients I have talked to don't know much about the milestones their child should be reaching and when. Most of the time its more thought of a circumstance that occurs when it does but they don't know at what times it should be something to get checked for developmental challenges. I am a strong believer in the concept that having more knowledge is good and I want to be able to provide my patients with whatever information they seek.

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I chose this topic because I feel like postpartum depression is a topic that is highly stigmatized. I feel like a lot of people expect new mothers to be excited about their newborns, but a lot of the time, they feel scared and anxious. I feel as though it is a topic that all healthcare providers should receive training on. By having this as a topic of my discussion I am taking the initiative and educating myself to advocate for my patients effectively.

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I chose this topic because although for the sake of this assignment, it is used in the context of mental health, these techniques can be used in every area of nursing. They are important tools that can be used during confrontational situations with patients. By choosing to educate myself on these techniques I will be able to apply these in practice to keep myself, my patients and my colleagues safe.

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"Listening is one of the most important aspects of therapeutic communication. It is through listening that we validate patients' emotions and begin to build trust"

Virginia Henderson (Nursing Theorist)

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This quote holds meaning as it easily explains the importance of active listening to validate the patient's emotions in a mental health situation. It is common in a mental health setting that the patients often feel invalidated and dependent on daily activities where they may feel scared or embarrassed by their emotions. Being able to listen, validate, and build trust with the patients is an essential skill needed for communication with patients and vulnerable populations.

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This picture holds meaning as, within mental health-focused populations, you are rarely aware of what one is thinking. By going in to communicating with patients and already being aware of that fact can help nurses build a deeper connection and level of trust with their patients.

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Artifact 3: Do's and Don'ts Reference Sheet

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Artifact 3: Do's and Don'ts Reference Sheet

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"addressing the social determinants of health is not just about improving the economy; it's about ensuring that every mother and child has the chance to thrive, no matter their background"

Dr. Linda Jones (Mental Health Advocate"

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As nursing students, we are constantly learning that health is not simply just biology. Health is a combination of multiple different factors such as housing, income, accessibility, and education. We have come to understand that early life conditions can impact long-term health. As the quote states, addressing these social determinants of health we are able to advocate for the changes needed to ensure that every mother and child have a healthy start to their lives.

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Social Determinants of Health on Maternal Health

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This infographic can be used as an important tool not just for nursing students but as an education tool for mothers. As nurses, an important part of our responsibilities is patient education. At times, with important and difficult topics, it can be difficult to adequately ensure that we are educating to the full extent but having a tool such as this infographic can help in ensuring that the importance of these topics are conveyed.

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During a clinical shift at PRHC, we had a patient who had not sought any prenatal care until 37 weeks gestation because there was a lack of transportation and care options available for her other 3 children.

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Artifact 1: Early Childhood Developmental Milestones Chart 

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Artifact 1: Early Childhood Developmental Milestones Chart 

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This table to me, is an education tool that I can use with my future patients to be able to adequately express the kind of milestones and accomplishments they should be expecting of their children in the coming years.

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My niece and nephew growing and learning how to do things together and learning how to be independent when they aren't together.

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This is an important experience to me as even though they are not my children (evidently because I am 19), I feel pride and joy when I get the chance to experience these milestones and learning experiences with them. Having this experience makes me feel like I will be able to connect on a deeper level with my patients when we discuss these milestones. I also feel like these experiences will render me a better educator for my patients as I will be educating based on acquired knowledge from research and school as well as my personal experiences.

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"there is in every child at every stage a new miracle of vigorous unfolding"

Erik Erikson

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Artifact 1: Self-Care Checklist for new Moms 

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Artifact 1: Self-Care Checklist for new Moms 

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self-care checklist for new mothers

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Similar to other artifacts, I find that this is an important teaching tool that can be potentially used in my future practice to emphasize that postpartum care isn't just about physical health but mental and emotional health as well. This checklist can be used to minimize the potential risk of PPD or negative mental health impacts among new moms.

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"Being a mother is learning about strengths you didn't know you had and dealing with fears you didn't know existed"

Linda Wooten

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This quote holds meaning to me because it highlights that motherhood brings forth unexpected challenges and fears. Many new mothers doubt themselves and their abilities to care for their newborns. As a nursing student, understanding these emotions and possibilities helps provide compassionate, patient-centred care.

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Artifact 3: Postpartum depression infographic 

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Artifact 3: Postpartum depression infographic 

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At clinical during our mental health placement, we got put into a situation with an aggravated patient who didn't want to cooperate. Regardless we got to see how the nurses handled that situation and got the patient to finally cooperate.

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This experience was meaningful to me because it was the first in-person experience with the de-escalation techniques we were taught. As I have said before, we can learn the topics as much as we want, but until we have that in-person experience, the learning doesn't do much. I find that I learned a lot during that experience, in terms of what order to use the techniques and what to do/react when they don't work.

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Artifact 2: De-escalation techniques infographic

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Artifact 2: De-escalation techniques infographic

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infographic

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de-escalation technique for mental health nursing infographic

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Again, I think this could be a useful tool for students during clinical to refer back to when talking to a combative patient. I enjoy having something quick to look at just as a refresher because mental health is not the only placement where these techniques can be useful in practice.

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As a nursing student, it is common and normal to feel not as confident in your skills, especially your communication with patients. Having a quick table such as this one to be able to reference, especially in a clinical setting before you go to talk to a patient can be a helpful tool to make you feel more confident with your abilities, and therefore make you a better nurse.

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This experience gave us a real-world insight into how it is that social determinants of health can influence the health outcomes of our patients. We can learn and study them all we want but ultimately unless we can recognize and act accordingly in a professional setting it is all theory. Being given the chance to experience this as saddening as it is, makes us better nurses.

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This quote is important to me because it emphasizes the continuous growth of children which is a key concept in pediatric nursing which is a field of interest of mine. It highlights how children are continuously growing and how even the littlest things can influence their development. As a nurse, we are part of these childrens lives in some of potentially the most vulnerable times of their lives, ad the way that we treat and care for them can continue to affect them throughout many years.

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Therapeutic Communication in Nursing - Nightingale College

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Discover in our guide the most essential nursing therapeutic communication techniques with examples & scenarios on how to apply them for better patient care.

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Similar to other artifacts, this is also an important educational tool. I find it to be useful that it has actual statistics and discusses the risks one has of being diagnosed with PPD. I think it is a topic that is not talked about often and is stigmatized throughout the community. I believe that it is a topic that should be discussed more often within the care setting, and having a useful tool to be able to educate effectively is also important.

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I find that situation cards are a useful tool to practice your therapeutic communication and what methods work the best when communicating with a patient expressing challenging behaviours. I find that if I practice skills, I'm able to think faster and more effectively on my feet in practice. Therefore, practicing scenario cards helps me understand it better considering the type of learner that I am .

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Ted Talk

https://www.ted.com/talks/alexandra_sacks_a_new_way_to_think_about_the_transition_to_motherhood

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Get a daily email featuring the latest talk, plus a quick mix of trending content.

By subscribing, you understand and agree that we will store, process and manage your personal information according to our Privacy Policy

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Alexandra Sacks: A new way to think about the transition to motherhood

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When a baby is born, so is a mother -- but the natural (and sometimes unsteady) process of transition to motherhood is often silenced by shame or misdiagnosed as postpartum depression. In this quick, informative talk, reproductive psychiatrist Alexandra Sacks breaks down the emotional tug-of-war of becoming a new mother -- and shares a term that could help describe it: matrescence.

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National Institute of Mental Health (NIMH)

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Perinatal depression is a mood disorder that occurs during pregnancy and after childbirth. The symptoms can range from mild to severe. In rare cases, the symptoms are severe enough that a mother and her baby's health and well-being may be at risk.

Perinatal depression can be treated. Learn about the signs and symptoms, risk factors, treatments, and ways you or a loved one can get help.

What is perinatal depression?

Perinatal depression includes depression that occurs during pregnancy (prenatal depression) and in the weeks after childbirth (postpartum depression). Most episodes of perinatal depression begin within 4−8 weeks after the baby is born. Women and other pregnant and postpartum people with perinatal depression experience extreme sadness, anxiety, and fatigue that may make it difficult to carry out daily tasks, including caring for themselves or others.

How is postpartum depression different from "baby blues"?

"Baby blues" is a term used to describe mild and short-lasting mood changes and feelings of worry, unhappiness, and exhaustion that many women experience in the first 2 weeks after giving birth. Babies require around-the-clock care, so it's normal for new mothers to feel tired or overwhelmed sometimes.

Mood changes and feelings of anxiety or unhappiness that are severe or last longer than 2 weeks after childbirth may be signs of postpartum depression. Women with postpartum depression generally will not feel better without treatment.

What are the signs and symptoms of perinatal depression?

Some women experience a few symptoms of perinatal depression, while others experience several symptoms. Some of the more common symptoms include:

Persistent sad, anxious, or "empty" mood most of the day, nearly every day, for at least 2 weeks

Feelings of hopelessness or pessimism

Feelings of irritability, frustration, or restlessness

Feelings of guilt, worthlessness, or helplessness

Loss of interest or pleasure in hobbies and activities

Fatigue or abnormal decrease in energy

Being restless or having trouble sitting still

Difficulty concentrating, remembering, or making decisions

Difficulty sleeping (even when the baby is asleep), waking early in the morning, or oversleeping

Abnormal changes in appetite or unplanned weight changes

Physical aches or pains, headaches, cramps, or digestive problems that do not have a clear physical cause and do not go away with treatment

Trouble bonding or forming an emotional attachment with the baby

Persistent doubts about the ability to care for the baby

Thoughts of death or harming oneself or the baby or suicide attempts

Women who experience any of these symptoms should see a health care provider. A provider can determine whether the symptoms are due to perinatal depression or something else.

What is postpartum psychosis?

Postpartum psychosis is a serious mental illness that can occur after childbirth. Women with postpartum psychosis may experience delusions (thoughts or beliefs that are not true), hallucinations (seeing, hearing, or smelling things that are not there), mania (a high, elated mood that often seems out of touch with reality), paranoia, and confusion.

Postpartum psychosis is a psychiatric emergency that requires hospitalization. Women experiencing symptoms of postpartum psychosis should seek immediate help by calling 911 or going to the nearest emergency room. Recovery is possible with professional help.

What are the risk factors for perinatal depression?

Perinatal depression is a medical condition that can affect any woman or pregnant and postpartum person, regardless of age, race, ethnicity, income, culture, or education. A woman is not to blame or at fault for having perinatal depression: It is not caused by anything she has or has not done.

Perinatal depression does not have a single cause. Research suggests that genetic and environmental factors contribute to the disorder. Specific factors contributing to perinatal depression can include:

Life stress (for example, demands at work or experiences of past trauma)

Physical and emotional demands of childbirth and caring for a new baby

Changes in hormones that occur during and after pregnancy

In addition, women are at increased risk for perinatal depression if they have a personal or family history of depression or bipolar disorder or if they experienced depression with a previous pregnancy. Women with a history of perinatal depression should consult a health care provider to develop a plan for follow-up care in case a depressive episode reoccurs.

How is perinatal depression treated?

Treating perinatal depression is critical for the health of the mother and her baby, as the disorder can have serious effects on both. However, with proper treatment, most women feel better and their symptoms improve.

Treatment for perinatal depression usually includes therapy, medication, or a combination of therapy and medication.

Researchers continue to study treatment options for perinatal depression. A health care provider can explain the different treatments and help you choose the best one based on your symptoms. Learn more about approaches for treating depression.

Psychotherapy

Several types of psychotherapy (also called talk therapy or counseling) can help women with perinatal depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Evidence-based therapies for perinatal depression include cognitive behavioral therapy and interpersonal therapy.

Cognitive behavioral therapy (CBT): With CBT, people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. People also learn different ways of reacting to situations. CBT can be conducted individually or with a group of people who have similar concerns.

Interpersonal therapy (IPT): IPT is based on the idea that interpersonal and life events impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues contributing to their depression.

Learn more about psychotherapy.

Medication

Medications used for depression (antidepressants) can effectively treat perinatal depression when used alone or in combination with psychotherapy. Antidepressants work by changing how the brain produces or uses certain chemicals involved in mood or stress.

Antidepressants take time-usually 4−8 weeks-to work. Problems with sleep, appetite, and concentration often improve before mood lifts. It is important to give a medication a chance to work before deciding whether it is right for you. You may need to try several medications to find the best one.

The U.S. Food and Drug Administration (FDA) has approved a medication called brexanolone specifically to treat severe postpartum depression. Brexanolone, which is administered through an IV during a brief hospital stay, appears to work differently than traditional antidepressants by rapidly altering a brain chemical that may play an important role in regulating the body's vulnerability to depression and anxiety.

More recently, the FDA approved a pill called zuranolone as the first oral medication for postpartum depression in adults. Zuranolone acts on similar brain receptors to brexanolone. In clinical trials, the pill reduced depressive symptoms in women with severe postpartum depression more quickly than traditional antidepressants.

Note: In some cases, people under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.

The risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low. However, women should always let a health care provider know if they are pregnant or nursing and work with the provider to minimize the baby's exposure to medication and weigh the risks and benefits of available treatment options. Find more information on medications during and after pregnancy on the FDA website .

All medications can have side effects. Talk to a health care provider before starting or stopping any medication. Learn more about antidepressants.

Learn about specific medications like brexanolone and zuranolone, including the latest approvals, side effects, warnings, and patient information, on the FDA website .

How can I find help for perinatal depression?

Visit a mental health professional

If you think you have perinatal depression, start by making an appointment with a health care provider. This could be a primary care doctor or a mental health professional who specializes in diagnosing and treating mental disorders (for example, a psychologist, psychiatrist, or social worker). A health care provider will examine you and talk to you about treatment options and next steps, including options if you are pregnant or nursing.

Communicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips for talking with a health care provider to improve your care and get the most out of your visit. For additional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website .

The Substance Abuse and Mental Health Services Administration has an online treatment locator to help you find mental health services in your area.

Join a support or advocacy group

Support or advocacy groups can be an important source of help and information. One example of this type of group is Postpartum Support International ; you can find others through online searches.

Contact the National Maternal Mental Health Hotline

This hotline offers free, confidential mental health support for mothers and their families before, during, and after pregnancy. Call or text 1-833-9-TLC-MAMA ( 1-833-852-6262) to connect with counselors 24 hours a day, 7 days a week. English- and Spanish-speaking counselors are available.

How can family and friends provide help for perinatal depression?

It is essential to understand that perinatal depression is a medical condition that impacts the mother, the child, and the family. Treatment is central to recovery.

Spouses, partners, family members, and friends may be the first to recognize signs of depression in a new mother. Family and friends can provide help in many ways that include:

Encouraging discussion with a health care provider

Helping get to appointments

Offering emotional or practical support

Assisting with daily tasks such as caring for the baby or home

Where can I learn more about depression in women?

The following agencies have additional information on depression in women:

For more information on postpartum depression, also see:

What are clinical trials and why are they important?

Clinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren't widely available.

NIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about  participating in clinical trials.

For more information

MedlinePlus (National Library of Medicine) ( en español )

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 23-MH-8116

Revised 2023

Reprints

The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

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This brochure provides information about perinatal depression including how it differs from the "baby blues", causes, signs and symptoms, treatment options, and how you or a loved one can get help.

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Continuing Education Activity

Therapeutic communication is an invaluable approach to interactions with patients that is applicable across multiple disciplines. This activity reviews therapeutic communication, including its history, definition, applications, and explains the interprofessional team's role in improving the care of patients through the use of therapeutic communication.

Objectives:

Describe the techniques used in therapeutic communication.

Outline the common pitfalls in patient-provider communication.

Identify the anticipated barriers to effective patient-provider communication.

Review interprofessional strategies that can advance therapeutic communication to improve patient outcomes.

Access free multiple choice questions on this topic.
Introduction

Therapeutic communication as a concept emerged early in medicine and has since shown significant benefits borne out in research. Two of the earliest reported cases of therapeutic communication, which primarily involved the idea of the therapeutic relationship and the benefits of such a relationship, were documented during the moral treatment era of asylums.[1] Both of the patients were admitted in 1791 and 1800, and both responded to moral treatment, despite having severe symptomatology.

In the late 1800s, Florence Nightingale had previously commented on the importance of the "communication that develops between the nurse and the patient" in the late 1800s.[2][3] She was quoted as saying, "Always sit within the patient's view, so that when you speak to him, he has not painfully to turn his head round to look at you. Everybody involuntarily looks at the person when speaking. So, also by continuing to stand, you make him continuously raise his eyes to see you...."

Function

Since the emergence of therapeutic communication as a concept in literature, it has been studied in various contexts. However, the definition of therapeutic communication has varied depending on the author and the context. C. M. Rossiter, Jr. brought this to attention in 1975, outlining several issues to consider with the definition of therapeutic communication.[15]

Later, a now generally accepted definition of therapeutic communication was proposed by Gwen van Servellen in 1997. In her text, therapeutic communication was defined as an exchange between the patient and provider using verbal and non-verbal methods. The ultimate goal of this communication style was considered to help the patient overcome some form of emotional or psychological distress.[16]

Issues of Concern

Personalize the Communication

Simultaneously, identifying and appreciating individual differences between patients is often considered important, as these differences account for many healthcare outcomes.[21][22] Commonly cited examples of such differences include social determinants of health and personality characteristics. In these ways, effective communication with individual patients can depend on a number of factors.[23] The following techniques of therapeutic communication must therefore be understood as general guidelines to patient-provider interactions. Providers can use these general guidelines as a foundational approach from which an individualized approach to communication can be used for specific patients.

Specific Techniques

These techniques are summarized in the following table:

*Note that eye contact and sitting near the patient for some individuals, including those with psychotic disorders and paranoia, could be destabilizing and should be used with caution. In cases where provider safety is uncertain, consider sitting at a safe distance without making the patient feel isolated.

Common Pitfalls

Additionally, there are several commonly used approaches with negative therapeutic value. These are summarized in the following table.

Clinical Significance

Therapeutic communication has been widely studied and has been shown to have multiple benefits.

As might be apparent, some of these identified barriers can be addressed at a systems level, and others at the level of patient-provider communication. One frequently expressed concern regarding therapeutic communication is that providers may not have enough time to address emotional concerns. This issue regarding lack of time has not been supported in the literature. Studies in physicians have demonstrated only a marginal change in the consultation time when an empathic response is given, and improved communication skills did not show an association with a longer duration of the consultation.[30] One observational study showed on average; empathic responses increased the duration of the consultation by only 21 seconds.[31]

Other predictors of successful therapeutic communication include differences in language, education difference between patient and provider, patient's education level, and perceived patient view scores.[32] Recognition of these differences and tailoring the communication style to the individual are therefore important considerations.

Other Issues

Communication can be complicated by other factors, including agitation/aggression, psychosis, delirium, and intubation. For these cases, utilizing therapeutic communication techniques and tailoring the individual patient's interaction can be particularly important.

In agitation, verbal de-escalation techniques are generally accepted as good clinical practice; however, it is an understudied field, especially in the setting of psychosis-induced aggression or agitation.[33] Non-psychosis-induced aggression has also been reviewed but has a limited evidence base as well.[34] Techniques for verbal de-escalation overlap greatly with the above listed therapeutic communication techniques, emphasizing balancing provider safety with patient comfort. These additional techniques include maintaining a moderate distance without appearing guarded, using calm and open body language and tone of voice, standing at a right angle to the client with an awareness of the exits, allowing the client to exit easily.[35]

Finally, psychosis presents a challenging communication barrier, especially concerning hallucinations and delusions. Development of a shared understanding in the setting of psychotic experiences becomes particularly challenging, both from the standpoint of the patient communicating their concerns to the provider and the provider reflecting an understanding of these concerns.[40] From the provider's standpoint, a conflict can emerge whether to respond in a manner that "colludes" with the psychotic experiences or to challenge them. Communication analysis has been used previously to analyze these encounters and has demonstrated a frequent pattern in which the patient tries to negotiate the meaning of the psychotic stimuli.[41]

One way to develop a shared understanding with patients with psychosis is to understand the meaning of the psychotic experiences to the patient, rather than focusing on the nature and content of the experiences themselves.[41] This might include active listening for the patient's feelings about their beliefs and experiences and validating distress around these experiences. A specific approach in literature termed Communication Skills Training (CST) has been cited as potentially beneficial, though further research is necessary.[42]

Enhancing Healthcare Team Outcomes

As noted above, therapeutic communication has shown multiple clinical benefits in the literature. Indeed, therapeutic communication has demonstrated improved patient satisfaction, among other noted benefits. Patient satisfaction as a concept is a complex and subjective concept, but it has contributed to improved medical outcomes. The mechanism by which therapeutic communication improves patient satisfaction is thought to occur by fulfilling the patient's expectations and values for the encounter. In turn, this fosters maintenance of the patient-provider relationship.[29] Additionally, another study demonstrated that effective communication styles during history taking and management plan discussion were associated with improved physical health outcomes, functional level, and blood pressure and glucose levels.[43] [Level 2] Further study is needed to strengthen these findings.

Each healthcare team member plays a vital role in therapeutic communication with the patient. Each team member gathers information from and subsequently communicates information to the patient in various contexts. This can be illustrated through a sample inpatient medical-surgical admission, where it is estimated that patients may see nearly 18 different healthcare providers through the course of the admission.[44] Each provider that sees the patient often has specialist information to obtain, including general and specialty medical, general or specialty surgical, psychiatry, psychology, nursing, patient education, clergy, social workers and case managers, and pharmacists.

Pharmacists also play an important role in therapeutic communication with patients and providers.[49] Multiple studies have shown the importance of effective pharmacist-patient communication in improving adherence and outcomes.[49] [Level 3]

Effective interprofessional communication is also considered critical in improving patient safety and improving outcomes. IPEC, in collaboration with the American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Dental Education Association, Association of American Medical Colleges, and the Association of Schools of Public Health, developed expert consensus guidelines on interprofessional collaborative practice.[50] Many of the above techniques, including openness, active listening, respectful language, and self-awareness, are considered critical to effective communication and collaboration. [Level 5]

Nursing, Allied Health, and Interprofessional Team Interventions

Given that team-based interventions primarily drive healthcare, all healthcare team members must be aware of and utilize therapeutic communication techniques. As such, the specific information gathered by each team member may also differ, and thus the collective information can allow for a more holistic treatment approach if all team members are involved and communicating. Tools like SBAR and STICC can provide efficient methods of interprofessional communication, and opportunities within the healthcare organization or system are important for supporting such communication.[51]

In addition, frequent and effective interprofessional communication is important to enhance treatment and prevent splitting behaviors in patients, where some providers may be considered "good" and others "bad." This is done by providing clear and consistent treatment recommendations that are from a "unified front," as well as a consistent message of compassionate treatment from all team members. Therapeutic communication can facilitate this through the use of consistent empathetic approaches provided by each healthcare team member.

Nursing, Allied Health, and Interprofessional Team Monitoring

Through therapeutic communication, the healthcare team can provide holistic monitoring of the patient's adherence, treatment response, adverse effects, and patient satisfaction, and identification of barriers to treatment. The biopsychosocial model of care provides a guide to approaching patients, and therapeutic communication techniques integrate well in identifying biopsychosocial contributors to health and illness in the patient.[55]

Interprofessional approaches to monitoring for and identifying these contributors to health and illness can also provide a powerful tool for approaching patient care. Monitoring the patient's emotional states from an interprofessional standpoint can also prove beneficial. In particular, monitoring these emotional states can allow for early identification of reactions a patient may be having towards a treatment or provider. In this way, one provider may provide liaison between these potential disruptions to care, address them early and directly with the patient, and simultaneously alert other team members to help patients work through these issues. Fostering therapeutic communication amongst interdisciplinary teams contributes to improving patient experience and enhancing health care outcomes.

References

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Therapeutic communication as a concept emerged early in medicine and has since shown significant benefits borne out in research. Two of the earliest reported cases of therapeutic communication, which primarily involved the idea of the therapeutic relationship and the benefits of such a relationship, were documented during the moral treatment era of asylums.[1] Both of the patients were admitted in 1791 and 1800, and both responded to moral treatment, despite having severe symptomatology.

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Girardi, G., Longo, M., & Bremer, A. A. (2023). Social determinants of health in pregnant individuals from underrepresented, understudied, and underreported populations in the United States. International Journal for Equity in Health, 22(1). https://doi.org/10.1186/s12939-023-01963-x

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Crear-Perry, J., Correa-De-Araujo, R., Johnson, T. L., McLemore, M. R., Neilson, E., & Wallace, M. (2020). Social and structural determinants of health inequities in maternal health. Journal of Women S Health, 30(2), 230–235. https://doi.org/10.1089/jwh.2020.8882

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Misirliyan, S. S., Boehning, A. P., & Shah, M. (2023, March 16). Development milestones. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557518/

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Jarocha, T. (2024, September 19). Complete guide to developmental milestones. Child Mind Institute. https://childmind.org/guide/parents-guide-to-developmental-milestones/

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Rabenschlag, F., Cassidy, C., & Steinauer, R. (2019). Nursing perspectives: reflecting history and informal coercion in de-escalation strategies. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00231

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Therapeutic Communication in Mental Health Nursing 

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Therapeutic Communication in Mental Health Nursing 

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SDOH Effects on Maternal Health Outcomes 

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SDOH Effects on Maternal Health Outcomes 

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De-escalation techniques in mental health nursing 

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De-escalation techniques in mental health nursing 

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Postpartum depression. (n.d.). CAMH. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/postpartum-depression

# data[].attributes.body
Tortorice, J. (2022, October 13). Article headline. Name. https://ceufast.com/blog/a-nurses-guide-to-de-escalation-techniques