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The relationship between the nurse and patient and the different approaches to counselling are equally important skills for today’s nurses in the contemporary hospital environment. Counselling must be internalised to be as much a part of a nurse's role as any physical or cognitive skill and care given not to have it viewed as only part of ideal practice, (Weaver, 2002). The counselling skills and approaches have both positive and negative qualities and need to be implemented in a case by case approach. This essay will explore the counselling skills such as active listening and nonverbal communication in the form of S.O.L.E.R (explained later) as a basis for implementing the different approaches such as cognitive behaviour therapy, the patient centred approach and an integrated approach. It is the relational dimension between nurses and patients that ignites the therapeutic capacity of these skills, (Weaver, 2002). An approach should not be used without having a basic knowledge of simple therapeutic relationship building blocks mentioned above. At the end of this essay the notion will be evident in that; the relationship between patient and nurse and the approach to counselling are equally important as you can’t have one without the other and be effective in helping your patient/client. No patients’ needs are the same what works for one patient may not be effective or applicable for the next.
There are many different types of approaches a nurse can take to help a patient. The approach taken will differ from patient to patient as will the relationship formed. Not all patients require a structured approach to help them manage/work through problems. For those with just small life problems or those with self-esteem problems a therapeutic relationship or someone to just listen might help them work though those issues. The qualities of a “good” counsellor are difficult to make official as there is a lack of concrete supporting research, (Wheeler, 2011). However, an effective counsellor is one who works with clients to produce a positive outcome, and a positive change in the client’s perception of themselves, (Wheeler, 2011). Some of these qualities include being intelligent, sincere, warm and of sound judgement, (Wheeler, 2011). In the first stage of therapy, counsellors must establish themselves with the client as being attractive, trustworthy and expert. These qualities are part of the therapist’s persuasive power to influence the client to trust both the individual therapist and the therapeutic process, (Wheeler, 2011).
Cognitive behaviour therapy has recently become a central feature of everyday nursing practice, (Freshwater, 2003). The goal of cognitive behaviour therapy (hereby referred to as C.B.T) is for clients to minimise the emotional disturbances and self-defeating behaviour and acquire a more realistic philosophy of life, (Corey, 1996). This type of approach would benefit for example a client by helping them embrace their treatment plans in an everyday situation, (Freshwater, 2003) . The relationship between the patient and nurse is one where the nurse encourages, persuades and directs the client with ways to challenge those self-defeating ideas like for example fears, (Corey, 1996). This approach is less intense then other approaches, (Corey, 1996). The negative to this approach is that the client must be willing to experiment with new behaviours which can be challenging for some patients, (Freshwater, 2003). It is evident that this approach would be suitable for specific patients only. However, you cannot discount its credibility and effectiveness and is equally important with some clients as developing a therapeutic relationship using solely counselling skills, (Corey, 1996).