4.6 : Techniques of Therapeutic Communication II: Focusing, Paraphrasing, and Summarizing

Focusing involves centering a conversation on a message's critical elements or concepts. Focusing is valuable if the talk is vague or patients begin to repeat themselves. Sometimes, when patients are asked about their symptoms, they may go off-topic and try to tell their entire life story. Respectfully, the nurse should bring the conversation back into focus.

This therapeutic technique can also be used when a patient brings up pertinent information during a health-related conversation. The nurse can shift the conversation to focus on the pertinent information that the patient provides. Consider a scenario in which a patient casually mentions they are suffering from knee pain. Then, the nurse might find it helpful to concentrate on this question: "How intense is the pain you are experiencing? Rate it from 1 to 10.

Paraphrasing is briefly restating another's message using one's own words. Through paraphrasing, nurses provide feedback informing patients they are actively involved in the search for understanding. Accurate paraphrasing requires practice. If the meaning of a message is changed or distorted through paraphrasing, communication becomes ineffective. For example, a patient says, "I've been overweight all my life and never had any problems. I can't understand why I need to be on a diet." An effective paraphrase of this statement would be: "You're not convinced that you need to make different food choices because you seem to have stayed healthy."

Summarizing is a highly effective therapeutic communication technique that draws attention to the main issues discussed, and the consensus reached at the end of the conversation. A nurse manager working with a disgruntled employee might summarize their interaction: "You've told me why you do not like this job and how unhappy you've been. You agreed to try a few of the solutions we've come up with, and you will let me know if these ideas improve your job satisfaction. We've also thought of some other potential solutions you can consider.”