Therapeutic Communication

Excerpt

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. 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. 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….”

In the 1950s, Harry Stack Sullivan and Jurgen Ruesch, prominent figures in interpersonal theory and communication, respectively, both published the importance of communication in providing therapeutic benefit, specifically in mental illness. Other significant contributors to the concept of therapeutic communication and related topics include Carl Rogers, Hildegard Peplau, and Tudor.

Of note, Hildegard Peplau published her original paper in 1952 and later published subsequent reviews and revisions in 1991 and 1997, which provided a foundation for the concept of therapeutic communication. This theory, named “Theory of Interpersonal Relations,” was founded on integrating knowledge of Sullivan’s interpersonal theory, as well as psychoanalysis, psychotherapy, and nurse therapy. Peplau's theory described multiple “phases” of the interaction and considered the relationship as a primary mediator for the healing process. The importance of the relationship to healing is accepted in common factors of psychotherapy research as a factor with empirical support. Other theorists include Travelbee, Rogers, and King, who have all contributed to the field of therapeutic communication.

“Therapeutic communication” ultimately emerged as a term in PubMed-indexed literature as early back as 1964 to 1965, in the setting of psychotherapy, psychiatry, sociology, medicine, rehabilitation, and nursing literature. Since then, the concept of therapeutic communication has expanded to apply to many other fields, particularly in healthcare. Other terms in the literature that overlap with therapeutic communication include patient-centered communication and therapeutic relationships.