Therapeutic
Communication
COMMUNICATION IS THE PROCESS that people use to exchange
information. Messages are
simultaneously sent and received on two levels: verbally through the use of
words and nonverbally by behaviors that accompany the words (DeVito, 2008). Verbal communication consists of the
words a person uses to speak to one or more listeners. Words represent the
objects and concepts being discussed. Placement of words into phrases and
sen-tences that are understandable to both speaker and listeners gives an order
and a meaning to these symbols. In verbal communication, content is the literal words that a person speaks. Context is the environment in which
communication occurs and can include the time and the physical, social,
emotional, and cultural environments. Context includes the situation or
circumstances that clarify the meaning of the content of the message.
Nonverbal communication is the behavior that
accompanies verbal con-tent such as body language, eye contact, facial
expression, tone of voice, speed and hesitations in speech, grunts and groans,
and distance from the listeners. Nonverbal communication can indicate the
speaker’s thoughts, feelings, needs, and values that he or she acts out mostly
unconsciously.
Process denotes all nonverbal
messages that the speaker uses to give meaning
and context to the message. The process component ofcommunication requires the listeners to observe
the behav-iors and sounds that accent the words and to interpret the speaker’s
nonverbal behaviors to assess whether they agree or disagree with the verbal
content. A congruent message is
conveyed when content and process agree. For example, a client says, “I know I
haven’t been myself. I need help.” She has a sad facial expression and a
genuine and sincere voice tone. The process validates the content as being
true. But when the content and process disagree—when what the speaker says and
what he or she does do not agree— the speaker is giving an incongruent message. For exam-ple, if the client says, “I’m here to
get help,” but has a rigid posture, clenched fists, an agitated and frowning
facial expression, and snarls the words through clenched teeth, the message is
incongruent. The process or observed behavior invalidates what the speaker says
(content).
Nonverbal process represents a more accurate message than does
verbal content. “I’m sorry I yelled and screamed at you” is readily believable
when the speaker has a slumped posture, a resigned voice tone, downcast eyes,
and a shameful facial expression because the content and process are congruent.
The same sentence said in a loud voice and with raised eyebrows, a piercing
gaze, an insulted facial expression, hands on hips, and outraged body lan-guage
invalidates the words (incongruent message). The message conveyed is “I’m
apologizing because I think I have to. I’m not really sorry.”
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