Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2024


Doctor of Nursing Practice (DNP)

Primary Advisor

Anthony J. Roberson, PhD, PMHNP-BC, FAANP


Background: Approximately 66% of residents at the project implementation site experience mental distress 3-7 days a week. The project implementation site does not incorporate therapeutic communication training in its continued education curriculum. Therapeutic communication training increases healthcare providers' patient-centered communication skills and self-efficacy, which correlates with a reduction in psychiatric patients' behavioral instabilities.

Objective: This project assessed whether healthcare providers' therapeutic communication education improves communication skills and self-efficacy.

Method: This quality improvement project was conducted at a group home organization that provides care for residents with mental illnesses and developmental disabilities. The project utilized a pre- and post-systematic, same-participant design and a pre-training resident satisfaction survey to establish a reliable baseline of participant nursing staff's communication skills. The nursing employees completed the opinion-based surveys, the CARE measure, and the S-12 before and after therapeutic communication training, which aided in comparing the impact on communication skills and self-efficacy relating with emotionally distressed residents.

Result: Fifty-four percent of residents identified that employee communication skills were fair before the training. Firty-three percent of participant employees identified that their communication skills were excellent before the training; after the training, 57% maintained that they were excellent, though post-training simulation performances were not excellent. Regarding self-efficacy in communicating with emotionally distressed residents, 66% of participants indicated they were certain, while 34% indicated they were very certain. After the training, 56% indicated they were very certain, while 42% indicted they were certain regarding their self-efficacy. Two months after the training, 5 (7%) of the initial 70 employee participants who completed both surveys indicated that their communication skills remained excellent and were very certain about their self-efficacy in interacting with emotionally distressed residents. The organization's management confirmed that the nursing staff's communication skills improved from fair to good post-communication training.

Conclusion: The correlation between therapeutic communication training and improving communication skills is inconclusive. Findings confirm that therapeutic communication training increases self-efficacy. The implication for future practice is that opinion-based communication measurement tools may not be as reliable as objective tools and real-time assessment of interactions between healthcare providers and distressed residents. A post-training resident survey regarding employee communication skills may also provide credible results about the impact of the communication training. For sustainability, therapeutic communication training should be incorporated into healthcare providers' continued education curriculum, as it has been proven in the literature to increase communication skills and self-efficacy.

Open Access


Available for download on Wednesday, April 09, 2025