Dialogue-Based Teaching for Health Communication: A Guideline for Nursing Educators

Abstract

Therapeutic communication is a core nursing competency and a focused form of health communication, particularly in mental health and psychiatric nursing, where students use the self as a therapeutic instrument to establish relationships, understand service users’ experiences, and respond purposefully. Memorizing communication techniques alone may be insufficient for complex and emotionally charged encounters. This academic article presents a conceptually grounded and practice-oriented approach to using dialogue to teach therapeutic communication. A narrative review of international and Thai databases and seminal theoretical sources was undertaken. The framework positions dialogue as the learning process, reflection as the mechanism that transforms experience into understanding, therapeutic communication as the competency outcome, and person-centered care as the distal outcome. A five-phase learning sequence is presented: creating a psychologically safe space, connecting with experience, listening and exploring meaning, professional reflection, and transfer to practice. A case example, instructor roles, sample prompts, and a multi-source assessment approach are provided. The framework integrates knowledge, communication skills, self-awareness, and clinical reasoning while maintaining psychological safety, voluntariness, confidentiality, and professional boundaries. Learning dialogue must not replace mental health treatment.