Chapter 2 – Therapeutic Communication and Interviewing
Therapeutic communication with clients and families requires attention to a person’s culture. It is important to note that:
- People are cultural beings. At a basic level, culture includes a person’s beliefs and values. It refers to a person’s practices or their way of life. It includes a person’s ethnicity, spirituality, and religion, but it is much more than these components.
- Culture is deeply embedded in each person and everything they do, including how they communicate and what is meaningful to them. It is essential to understand because it shapes the way we think, feel, and behave. It can determine what is considered taboo, appropriate, and meaningful.
- Culture is socially transmissible (Kashima, 2019) meaning that it can be passed from one person/generation to the next, making verbal and non-verbal communication a vital way to impart and share culture. Often, from an Indigenous perspective, culture is not merely the sum of a person’s individual characteristics; “it is an emergent property of individuals interacting with their natural and human environment” (Kim, Park, & Park, 2000, p. 67). As a result, culture is not static – cultural patterns are dynamic and shift throughout a person’s life.
Cultural safety is an important component of therapeutic communication, because culture is so dynamic and deeply embedded in a person’s way of being. In the context of therapeutic communication, you must examine your own culture and how it affects the ways you communicate with clients. This self-awareness is vital to provide culturally safe care to clients and facilitate (Curtis et al., 2019).
A relational approach can facilitate communication that embraces cultural safety because it relies on your dialogical engagement with the client. In other words, nurses should suspend what they assume they know about culture, and let clients direct nurses with regard to how culture is meaningful to them. This approach encourages you to consider the relational interplay (Doane & Varcoe, 2015) of communication, the client’s culture, and your own culture. Like everyone, nurses are cultural beings with ethnocentric tendencies – you will tend to view the world and your client from your own cultural perspective. From a relational perspective, you must understand your own culture and your ethnocentric tendencies so that you are positioned to recognize and understand the client’s culture.
Part of a relational approach also involves positioning yourself as an inquirer who is in a “space of knowing/not knowing, being curious, looking for what seems significant” (Doane & Varcoe, 2015, p. 6). See Table 2.3 on how to develop yourself as an inquirer and understand the interplay of your culture and the client’s culture.
Table 2.3: Understanding culture.
Your Own Culture
The Client’s Culture
How do you define your culture?
What does a typical day involve for you?
How does your culture affect your health and illness?
What are your own biases, attitudes, prejudices that may affect how you care for and communicate with the client?
If you were in the client’s shoes, what would be important for you to share with your nurse about your culture so that they could better care for you?
Tell me about your culture.
Tell me about a typical day for you.
Tell me about what is important to know about your culture in order to care for you best.
How can I provide care to you that is culturally safe?
Activity: Check Your Understanding
Fair opportunity to reach one’s fullest health potential.