A nurse is designing an educational poster on therapeutic communication techniques for staff nurses. Which of the following techniques should the nurse include as an example of therapeutic communication?

Therapeutic communication involves purposeful use of verbal and nonverbal techniques to establish trust, promote patient expression, and facilitate accurate assessment of psychosocial and physical needs. It supports effective nurse–patient relationships by encouraging open dialogue, active listening, and patient-centered engagement. Rationale: A. Sympathy reflects emotional involvement and may shift focus from the patient to the nurse’s feelings. It can impair objectivity and is not considered therapeutic. Therefore emotional bias expression does not support effective therapeutic communication. B. Open-ended questions encourage clients to express thoughts, feelings, and concerns in detail, promoting deeper assessment and patient engagement. This technique enhances therapeutic dialogue and trust. Thus exploratory questioning is a core therapeutic communication strategy. C. Avoiding silence is incorrect because therapeutic communication often uses purposeful silence to allow reflection and emotional processing. Interrupting silence may limit patient expression. Therefore lack of reflective pause is not therapeutic. D. Distraction diverts attention away from the client’s concerns and may invalidate their feelings. It does not facilitate exploration or understanding of issues. Thus avoidance strategy is not an effective therapeutic communication technique.