What is the goal of therapeutic communication?
Promotes healing and wellbeing, builds trust and a therapeutic relationship, patient-centred and empathetic.
What types of questions should be avoided in therapeutic communication?
“Why?” questions (feels interrogative), multiple or closed questions.
What areas should therapeutic communication cover?
Cognitive, affective, behavioural, and time-oriented aspects.
What factors can affect communication effectiveness?
Education level, first language, readiness, confidentiality, environment, confidence.
What communication styles or behaviours should be avoided?
Clichés, contradiction, criticism, ridicule, sarcasm, indifference, lecturing, stereotyping.
What are the 10 principles of de-escalation?
Respect personal space
Don’t be provocative
Establish verbal contact
Be concise
Identify wants/feelings
Listen closely
Find areas of agreement
Set clear limits
Offer choices and optimism
Evaluate outcome and next steps
Noradrenaline/Epinephrine
Concentration - Excitatory, main neurotransmitter in sympathetic nervous system, wakening, memory, alertness
Dopamine
Pleasure - Excitatory and inhibitory, only in midbrain, responsible for feeling and acting
Serotonin
Mood - Emotional, physiological, metabolic, cognitive regulation
GABA
Calming - Inhibitory, deficiency contributes to anxiety disorders
Acetylcholine
Learning - Primary role in cognitive processes
Glutamate
Memory - Excitatory
Olanzapine
Class: Atypical antipsychotic
MOA: Blocks serotonin, dopamine, histamine
Route: PO (onset 10–20 min; duration 12–24 hr)
Contra: Hypersensitivity
Adverse: Sedation, dizziness, tremors
Lorazepam
Class: Benzodiazepine
MOA: Enhances GABA → sedation
Route: PO (onset 30–60 min; duration ~8 hr)
Contra: Hypersensitivity, hypotension, myasthenia gravis
Adverse: Respiratory depression, drowsiness, confusion
Midazolam
Class: Benzodiazepine
MOA: Enhances GABA → sedation
Route: IM (<10 min; ~2 hr), IV (1–2 min; ~2 hr)
Contra: Allergy, hypotension, shock
Adverse: Respiratory depression, apnoea, hypotension
Droperidol
Class: Antipsychotic
MOA: Dopamine blockade → sedation
Route: IM (onset 3–10 min; duration 2–4 hr)
Contra: Allergy, Parkinson’s disease, Lewy body dementia
Adverse: Extrapyramidal symptoms (EPS), hypotension
Ketamine
Class: Anaesthetic/sedative/analgesic
MOA: NMDA receptor antagonist → dissociative sedation
Route: IV (30 sec; 10 min), IM (3–4 min; 12–25 min)
Contra: Hypersensitivity, severe hypertension
Adverse: Hypertension, tachycardia, respiratory depression
