Communication Skills

Effective communication with schizophrenic patients is particularly important because they are so easily overwhelmed by the external environment. Skillful communication can make an enormous difference in the ability of patients and families to resolve the problems of daily living.

Good communication involves:
1. Knowing when to communicate
2. Knowing what to communicate
3. Knowing how to communicate.

When to Communicate

Don't discuss something important when you are angry or upset. It's hard to think clearly, listen well, and focus on constructive solutions. Before talking to your relative, take as much time as you need to calm down.

What to Communicate About

Since schiophrenia is a serious disorder that affects not only the patient but others around the patient, there are usually several problem areas that family members want to address. Bringing up several problems at once will overwhelm your relative, so it's best to select one problem at a time. Choose one problem area that is really important, then focus on a specific behavior you'd like your relative to change. For ex., say, "John, please stop playing your radio so loudly after 10 p.m." Don't say, "John, you're too noisy at night."

How to communicate

Communication has two levels, verbal and nonverbal. Verbal communication is the what you actually say.

Keep all your verbal communication simple, brief, and specific. Nonverbal communication refers to how you say it--your tone of voice, posture, eye contact, facial expression, and physical distance between speakers. The nonverbal "message" that comes across is often more important than the the verbal message.

Guidelines for non-verbal communication:

1. Stand close to your relative, but don't crowd his/her personal space.

2. Convey interest, concern and alertness through your body posture and facial expression. 3, Maintain eye contact with your relative.
4. Speak calmly and clearly.


Expressing positive feelings.
1. Look at the person.
2. Say exactly what the person did that pleased you.
3. Tell the person how their behavior made you feel. (Bad ex.: "You are nice to have around the house." Good ex.: "I like it when you do a nice job cleaning the kitchen").

Making a positive request.
1. Look at the person.
2. Say exactly what you would like the person to do.
3. Tell how it would make you feel.
4. Use phrases like "I would like you to...." or "I would really appreciate it if you would....."

Expressing negative feelings.
Look at the person.
Say exactly what the person did that upset you.
Tell the person how it made you feel.
Suggest how the person might prevent this from happening in the future. (Bad ex. "You are a frightening person." Good ex. "I get very nervous when you pace around the room.")

Active listening
1. Look at the speaker.
2. Attend to what is said.
3. Nod head, say, "Uh-huh".
4. Ask clarifying questions.
5. Check out what you heard.

This article was posted by D.J. Jaffe on behalf of the Alliance for the Mentally Ill/Friends and Advocates of the Mentally Ill