TYPES OF RELATIONSHIPS
Each relationship is unique because of the various combi-nations of traits and characteristics of and circumstances related to the people involved. Although every relation-ship is different, all relationships may be categorized into three major types: social, intimate, and therapeutic.
A social relationship is primarily initiated for the purpose of friendship, socialization, companionship, or accom-plishment of a task. Communication, which may be super-ficial, usually focuses on sharing ideas, feelings, and expe-riences and meets the basic need for people to interact. Advice is often given. Roles may shift during social inter-actions. Outcomes of this kind of relationship are rarely assessed. When a nurse greets a client and chats about the weather or a sports event or engages in small talk or social-izing, this is a social interaction. This is acceptable in nurs-ing, but for the nurse–client relationship to accomplish the goals that have been decided on, social interaction must be limited. If the relationship becomes more social than therapeutic, serious work that moves the client for-ward will not be done.
A healthy intimate relationship involves two people who are emotionally committed to each other. Both parties are concerned about having their individual needs met and helping each other to meet needs as well. The relationship may include sexual or emotional intimacy as well as shar-ing of mutual goals. Evaluation of the interaction may be ongoing or not. The intimate relationship has no place in the nurse–client interaction.
The therapeutic relationship differs from the social or intimate relationship in many ways because it focuses on the needs, experiences, feelings, and ideas of the client only. The nurse and client agree about the areas to work on and evaluate the outcomes. The nurse uses communica-tion skills, personal strengths, and understanding of human behavior to interact with the client. In the thera-peutic relationship the parameters are clear: the focus is the client’s needs, not the nurse’s. The nurse should not be concerned about whether or not the client likes him or her or is grateful. Such concern is a signal that the nurse is focusing on a personal need to be liked or needed. The nurse must guard against allowing the therapeutic rela-tionship to slip into a more social relationship and must constantly focus on the client’s needs, not his or her own.
The nurse’s level of self-awareness can either benefit or hamper the therapeutic relationship. For example, if the nurse is nervous around the client, the relationship is more apt to stay social because superficiality is safer. If the nurse is aware of his or her fears, he or she can discuss them with the instructor, paving the way for a more therapeutic rela-tionship to develop.