1st Edition

Therapeutic Communication in Mental Health Nursing
Aesthetic and Metaphoric Processes in the Engagement with Challenging Patients

ISBN 9781138244290
Published March 10, 2017 by Routledge
84 Pages

USD $69.95

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Book Description

Awarded first place in the 2017 AJN Book of the Year Awards in Psychiatric and Mental Health Nursing.

This book introduces an innovative technique for therapeutic communication in mental health nursing, expanding the toolkit for nurses seeking to engage challenging patients who have not responded to more conventional therapeutic methods. Linking nursing communication to current research on metaphor and figuration, it is illustrated with accessible clinical examples.

Metaphor is a key component of talk-based psychotherapies. But many of the patients whom nurses encounter in the inpatient setting are not good candidates for talk-based approaches, at least initially, because they are violent, withdrawn, highly regressed, or otherwise lacking a vocabulary to convey thoughts and feelings. This book offers specific clinical examples of an approach called the "gestural bridge." This is a method for structuring games and physical activities which connect metaphorically to a patient’s personal themes, activating narrative and observational agency and enabling an exchange of meaning to begin at a time when conventional language is not available. Rooted in what nursing theorists have called the "embodied" or "aesthetic" way of knowing, this approach is both specific and easily grasped.

Drawing from contemporary work in literary theory, semiotics, metaphor theory, cognitive science, philosophy, linguistics, psychoanalysis, and the arts, Therapeutic Communication in Mental Health Nursing is important reading for advanced-level practitioners, students, and researchers interested in communication and relationship-building in nursing.

Table of Contents

  1. Introduction
  2. The Gestural Bridge
  3. Metaphors and Representations
  4. Garden Metaphors
  5. The House as Grammatical Form
  6. Rhythm and Regularity
  7. Nursing Knowledge and Nursing Art: Implications for Learning and Professional Training
  8. Conclusion: Figurativity and Metaphoric Process in the Nursing Toolkit

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Shira Birnbaum is a psychiatric nurse, educator, writer, and artist. She graduated from Barnard College, Columbia University, and has worked with chronically and acutely mentally ill adolescents, adults, and homeless in a variety of institutional and outreach settings in the New York and Philadelphia metropolitan areas. She is a project manager at the Brookdale Center for Healthy Aging at Hunter College, City University of New York.


"I believe this book is quite unique, and necessary, at a time when much of psychiatric nursing practice, (at least at the master’s level), consists of dispensing prescriptions for psychotropic medication. Psychiatric nursing is much more than this, and we must not lose the essential relational elements of our practice. The innovative approaches to patients who are not amenable to "talk therapies" will be useful to hospital nurses and students. I believe the book will be inspirational to all readers. The case examples are so vivid and beautifully narrated." – Professor Sandra Thomas, University of Tennessee, Knoxville, USA

"The strength of the book is in bringing alive the lives of people who are struggling with severe mental health problems. Mental health nurses are often on the frontline, and it is from that position of intimacy that this book makes a unique contribution. The style and quality of writing is impressive, in places poetic…The author has frontline experience, and writes with compassion and diligence." – Associate Professor Gary Winship, University of Nottingham, UK

"An important contribution for those seeking innovation in communication can be found in Shira Birnbaum's new book. This volume is slim but contains a surprising amount of thought-provoking information…Each chapter shares new insights. Birnbaum discusses how to have conversations without speaking, how complex metaphors can be communicated through simpler activities, and how to allow individuals to express themselves through their specialized interests…The author does not dive into nursing theory or extensive policy dissection, instead focusing on real life cases of meaningful patient encounters…After finishing this book, readers have enough information to form their own ideas about how they can implement these interventions into their own work with challenging mental health populations. For those who work with individuals not considered ideal candidates for talk-based psychotherapies, this book is highly recommended." – Issues in Mental Health Nursing