J Korean Acad Psychiatr Ment Health Nurs.  2019 Dec;28(4):321-332. 10.12934/jkpmhn.2019.28.4.321.

Exploring the Therapeutic Communication Practical Experience of Mental Health Nurses

  • 1Assistant Professor, Department of Nursing, Semyung University, Jecheon, Korea.
  • 2Assistant Professor, Department of Nursing, Dongguk University, Gyeongju, Korea. gml34@dongguk.ac.kr


The purpose of this study was to explore the therapeutic communication experience of nurses in psychiatric wards.
Data were collected from 9 mental health nurses working at psychiatric wards in three university hospitals in Seoul and Gyeongju, South Korea. The study involved in-depth individual interviews, which were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis.
Therapeutic communication experiences of psychiatric ward nurses were categorized into 4 categories, 12 subcategories, and 24 codes. The four categories were "˜therapeutic communication practiced as a nurse', "˜therapeutic communication delivered to patients', "˜power revealed between patients and nurses', and "˜environment surrounding therapeutic communication'. The twelve subcategories were "˜approaching with interest', "˜with all one's heart and soul', "˜learning and grow from peers', "˜understanding the true meaning of mental health nursing', "˜boosting in strength', "˜providing a sense of security', "˜formation of rapport', "˜lead to recovery', "˜variability of interaction', "˜powerful energy originating from sparklet', "˜lack of physical time', and "˜absence of supervision'.
The results of this study indicate the need to develop and apply therapeutic communication interventions for psychiatric nurses. Supervision is needed to promote therapeutic communication among psychiatric nurses and requires institutional support.


Qualitative research; Psychiatric nursing; Nurses; Patients; Communication

MeSH Terms

Hospitals, University
Mental Health*
Organization and Administration
Psychiatric Nursing
Qualitative Research


1. Cleary M, Hunt GE, Horsfall J, Deacon M. Nurse-patient interaction in acute adult inpatient mental health units: a review and synthesis of qualitative studies. Issues in Mental Health Nursing. 2012; 33(2):66–79. DOI: 10.3109/01612840.2011.622428.
2. Yim HB, Koh OJ, Cho H, Kim HK, Chang SO, Shon JN. Study on the perceived concept about therapeutic communication of nurses working in psychiatric ward. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 1996; 5(1):88–99.
3. Park JW. The experiences of psychiatric patients about nurses' nonverbal communication behaviors in interpersonal relationship. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2000; 9(1):35–43.
4. Fleischer S, Berg A, Zimmermann M, Wüste K, Behrens J. Nurse-patient interaction and communication: a systematic literature review. Journal of Public Health. 2009; 17(5):339–353. DOI: 10.1007/s10389-008-0238-1.
5. Im SB. Nurse-client therapeutic communication: active listening and feedback. Korean Academy on Communication in Healthcare. 2009; 4(1):43–48.
6. McLaughlin C. An exploration of psychiatric nurses' and patients' opinions regarding in-patient care for suicidal patients. Journal of Advanced Nursing. 1999; 29(5):1042–1051. DOI: 10.1046/j.1365-2648.1999.01000.x.
7. Park HJ. Counseling self-efficacy and empathic ability of the psychiatric nurses [master's thesis]. Seoul: Ewha Womans University;2012. 70.
8. Martin CT, Chanda N. Mental health clinical simulation: therapeutic communication. Clinical Simulation in Nursing. 2016; 12(6):209–214. DOI: 10.1016/j.ecns.2016.02.007.
9. Birnbaum S. Freud still matters to nursing: a response to Sandra P. Thomas. Issues in Mental Health Nursing. 2015; 36(12):1017–1018. DOI: 10.3109/01612840.2015.1063027.
10. Fakhr-Movahedi A, Salsali M, Negharandeh R, Rahnavard Z. A qualitative content analysis of nurse-patient communication in Iranian nursing. International Nursing Review. 2011; 58(2):171–180. DOI: 10.1111/j.1466-7657.2010.00861.x.
11. McCabe C. Nurse-patient communication: an exploration of patients' experiences. Journal of Clinical Nursing. 2004; 13(1):41–49. DOI: 10.1111/j.1365-2702.2004.00817.x.
12. Donovan LM, Mullen LK. Expanding nursing simulation programs with a standardized patient protocol on therapeutic communication. Nurse Education in Practice. 2019; 38:126–131. DOI: 10.1016/j.nepr.2019.05.015.
13. Lee JS, Park SM, Chun SS, Choi JS, Kim MO, Kim R, et al. Communication experiences between psychiatric nurses and patients. Korean Academy of Psychiatric and Mental Health Nursing. 2002; 11(4):596–608.
14. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005; 15(9):1277–1288. DOI: 10.1177/1049732305276687.
15. Lincoln YS, Guba EG. Naturalistic inquiry. California, USA: Sage Publications Inc.;1985. p. 416.
16. Kim SH. Aspects of the promotion of psychiatric nurse and communication skills to communicate ever on the relationship between self-efficacy [master's thesis]. Seoul: Korea University;2006. 53.
17. Oh E, Lee MH, Ko SH. Influence of emotional intelligence and empathy on the facilitative communication ability of psychiatric nurses. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2016; 25(4):283–293. DOI: 10.12934/jkpmhn.2016.25.4.283.
18. Lee HS, Kim JK. Relationship among communication competence, communication types, and organizational commitment in hospital nurses. Journal of Korean Academy of Nursing Administration. 2010; 16(4):488–496. DOI: 10.11111/jkana.2010.16.4.488.
19. Kounenou K, Aikaterini K, Georgia K. Nurse's communication skills: exploring their relationship with demographic variables and job satisfaction in a Greek sample. Procedia- Social and Behavioral Sciences. 2011; 30:2230–2234. DOI: 10.1016/j.sbspro.2011.10.435.
20. Bramhall E. Effective communication skills in nursing practice. Nursing Standard. 2014; 29(14):53–59. DOI: 10.7748/ns.29.14.53.e9355.
21. Loureiro C, Quaresma H, Santos JC. Psychiatric/mental health nursing core competencies: communication skills. European Psychiatric/Mental Health Nursing in the 21st Century. 2017. 29:p. 259–267. DOI: 10.1007/978-3-319-31772-4_20.
22. Lim SB, Kim SA, Kim SJ, Lee S, Sin SH, Kim SS, et al. Psychiatric mental health nursing. Seoul: Soomoonsa;2015. p. 827.
23. Harris BA, Panozzo G. Therapeutic alliance, relationship building, and communication strategies-for the schizophrenia population: an integrative review. Archives of Psychiatric Nursing. 2019; 33(1):104–111. DOI: 10.1016/j.apnu.2018.08.003.
24. Olivia G. Essential therapeutic communication training for mental health nurses: a program evaluation [dissertation]. North Carolina: University of North Carolina;2019. 77.
25. Vandewalle J, Beeckman D, Van Hecke A, Debyser B, Deproost E, Verhaeghe S. Contact and communication with patients experiencing suicidal ideation: a qualitative study of nurses' perspectives. Journal of Advanced Nursing. 2019; 75(11):2867–2877. DOI: 10.1111/jan.14113.
26. Sveinbjarnardottir EK, Svavarsdottir EK. Drawing forward family strengths in short therapeutic conversations from a psychiatric nursing perspective. Perspectives in Psychiatric Care. 2019; 55(1):126–132. DOI: 10.1111/ppc.12329.
27. Harris B, Panozzo G. Barriers to recovery focused care within therapeutic relationships in nursing: attitudes and perceptions. International Journal of Mental Health of Nursing. 2019; 28(5):1220–1227. DOI: 10.1111/inm.12611.
28. Loughland C, Kelly B, Ditton-Phare P, Sandhu H, Vamos M, Outram S, et al. Improving clinician competency in communication about schizophrenia: a pilot educational program for psychiatry trainees. Academic Psychiatry. 2015; 39(2):160–164. DOI: 10.1007/s40596-014-0195-7.
29. McCabe R, John P, Dooley J, Healey P, Cushing A, Kingdon D, et al. Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised controlled trial. The British Journal of Psychiatry. 2016; 209(6):517–524. DOI: 10.1192/bjp.bp.115.179499.
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