Building and Maintaining Relationships in the Digital Age: Using Social Penetration Theory to Explore Communication through Social. Insofar as one is interested in building a connection, a person will share more both A recent resurgence in interest in the theory in relation to communication. Let us go through the theories of interpersonal relationship development in detail. Strangers must communicate well to know each other better and find out.
The theory is a processual one that highlights the development, maintenance, and deterioration of social relationships. We can find four stages defined in the original statement: Individuals are cautious and tentative in their interaction, and these interactions are ruled bye social conventions and formulas. Interactants are more relaxed and friendly with each other.
Many barriers have been broken down, and a great deal of open exchange occurs.
This stage would often characterize close friendships and romantic relationships. Is characterized by continued openness and richness interaction. Interactants understand each other very well, and communication can occur at eh nonverbal level. Both relation development and relational disintegration occur as a linear progression through these varying stages of intimacy.
Breadth and Depth of communication According to social penetration theory, relationships develop as overt interpersonal behaviors move from the superficial to the intimate, and the most central of these behaviors is communication. Altman and Taylor propose an onion model to describe the ways in which communication shifts as relationships move through varying stages of intimacy.
The onion is an apt metaphor, because it includes both clear layers through which communication in relationships can travel and a round surface that suggests varying points of entry for moving to the center of the onion. Self-Disclosure and Reciprocity The behavior process through which this breadth and depth of interaction is achieved is self-disclosure. It involves communication about self and can include both intimate and nointimate topics.
Several overall patterns are particularly important to an understanding of social penetration theory: That is, when one person reveals something about himself or herself, the other person will tend to reply with similar information.
Reciprocity is a norm, thought, not a universal law. Social Exchange There are a few relationships that people value highly and cant to keep at an intimate level.
People also have preferences for movement among relational stages, as persons talk about their desire to move a relationship to a new level or get some distance in a friendship. According to social penetration theory, it is the important process of social exchanges the motivational force that drives the desires and that pushes an pulls relationships from one stage to another. This theory establishes that individuals evaluate relationships in a relatively rational manner akin to an economic analysis.
This analysis involves an assessment of the rewards derived from a relationship, the costs of a relationship, and the rewards and costs that are perceived form past relationships. These concepts come together in defining relational outcomes, comparison levels and comparison levels of alternatives. Critiques of the theory There have been many critiques of the theory since its inception.
Some scholars question the value of an economic model in the realm of relational decision. In addition to this concern other scholars questions the ideological basis of the theory, because it was developed in a period when openness was highly value for self-disclosure and relational intimacy. And finally, social penetration theory has also been criticized because of the linear structure proposed in the theory.
To many, it seems intuitively clear that relationships are not on a direct march toward intimacy.
The theory has also generated a great deal of controversy. Original statement The theory was proposed by Charles Berger and Richard Calabrese as a first effort to model the process of interaction during the initial stage of relational development.
In considering only the entry stage of relational development, Berger and Calabrese are clearly narrowing the longitudinal focus from the long term frame considered in social penetration theory. Self-disclosure increases after individuals have had satisfactory or rewarding interactions with others.
Social penetration is defined by breadth number of topics discussed and depth how personal is the information being discussed [ 55 ]. The provider may question the patient regarding sexual practices, drug and alcohol use, history of depression, etc.
- I. Introduction
- THEORIES OF COMMUNICATION IN DEVELOPING RELATIONSHIPS
The vast amount of this information is one-sided with the provider asking multiple questions, but not sharing equally private information with the patient. Hence, the normal pattern of social penetration, occurring over time and being reciprocal, is often violated in provider-patient relationships. Reciprocation is a strong motivation in human behavior; individuals perceive a sense of obligation to repay what has been provided to them [ 58 ].
This rule is so well ingrained in human society, that those who continually avoid reciprocation whether it be kindness, time, money, etc. Providers cognizant of this norm may be able to activate it simply, such as complimenting a patient or offering some new information; this behavior then may be perceived by the patient as a benefit afforded to him [ 59 ].
Most research using Social Penetration Theory or the norm of reciprocity is focused on relationships e. The authors suggested that this expansion of Social Penetration Theory assisted in explaining how family caregivers of elders with dementia interacted with the formal and informal care systems within a nursing home.
Others have identified Social Penetration Theory and the norm of reciprocity in conjunction with Social Exchange Theory as a foundation for their research, applying it to the pharmacist-patient domain [ 61 ].
One Dutch study reported that medical residents perceiving reciprocal relationships with supervisors were less likely to perceive emotional exhaustion and depersonalization than those perceiving that they were under-benefiting in such relationships [ 62 ].
Many other studies have assessed the effect of physician self-disclosure on patient outcomes such as satisfaction and visit content and others have sought to describe physician disclosures [ 6364 ].
However, these studies have not specifically identified Social Penetration Theory or the norm of reciprocity as underlying theoretical foundations.
Numerous scholars also have assessed or commented on the topic of professional boundaries between patients and providers e.
Originally applied to personal relationships, but quite relevant to the provider-patient relationship, CPM suggests that both individual and collective boundaries are constructed around information deemed private.
Boundaries regulate who is perceived to have control over the private information, who has access to the information, and how to protect that information from those outside the applied boundaries [ 67 ].
The most recent overview of CPM discusses six underlying principles of the theory: Per CPM, an inherent push-pull is constant when revealing private information, often creating a dialectic tension, or opposing perspective. A critical understanding of the theory necessitates understanding that private information is usually believed to be owned, or possessed, and that personal and collective boundaries are constructed around this information.
CPM argues that successful communication is more likely when those involved explicitly acknowledge the existence of private information and together determine privacy rules and boundaries e. More recently, CPM has been used in the context of stressors associated with the early survivorship of breast cancer [ 72 ], as well as exploring how physicians may deliver bad news [ 73 ].
Summary Theories categorized as relationship-centered tend to focus on the disclosure of information within a communication encounter.
Theories of Interpersonal Relationship
Application of these theories allows us to better understand and further explain the communication, or lack thereof, of information within a medical encounter among multiple individuals. Discussion and Conclusion 5. Discussion Due to the interpersonal nature of healthcare communication, an understanding of interpersonal communication theories can affect both research and practice. Results can address questions arising in provider-patient contexts and lead to additional questions for future exploration.
We find this framework particularly useful in thinking about how to apply interpersonal communication theories to healthcare communication practice and research. Three of these ways of being theoretical grounding, referencing, and interpretation are particularly relevant to the theories presented here, both in terms of past and future uses. First, studies can be grounded by using a theory as a starting point. A researcher might choose to test GPA Theory in healthcare communication by designing a study asking physicians to watch a recording of themselves interacting with a patient and write down their thoughts at regular intervals in the interaction.
Second, researchers often reference theory when discussing a conceptual framework for a particular study. For instance, healthcare communication researchers studying empathy may reference facework as a contributing theory to the conceptual framework used in their study.
Finally, theories can contribute to the interpretation of study findings, such as using Uncertainty Management Theory as a framework when analyzing focus group data. Opportunities for utilization of interpersonal communication theories in healthcare communication research are vast. UMT can continue to serve as a foundation for studies seeking to explain why some patients actively search for information in health contexts while others avoid it, which can aid providers in better tailoring their communication to the needs and preferences of their patients.
Interaction-centered theories provide thorough descriptions of what happens in healthcare communication. Connecting these descriptions with patient outcomes could occur via the application of CAT to healthcare.
Theories of Interpersonal Relationship
Building upon previous work in operationalizing the theory in healthcare interactions [ 39 ], further work might examine how specific acts of convergence and non-convergence contribute to a patient-centered interaction. Facework and politeness theories could be applied to healthcare consultations wherein a provider is discussing health risks with patients.
For example, do more face-saving strategies lead to better outcomes in the context of tobacco cessation discussions? Rigorous study of speech codes in provider-patient interactions could lead to a better understanding of misunderstandings and non-adherence. To apply relationship-centered theories, we must first recognize that often we are violating rules of social penetration theory and that such unequal and rapid penetration can have an effect on the future of the provider-patient relationship.
However, reciprocity does not operate in every context. Future research may consider identifying contexts or types of interactions e. There are certainly some limitations to note about our discussion of these theories. The theories discussed were not originally developed for application within the healthcare contexts. However, as many aspects of interpersonal communication, both verbal and non-verbal, arise in healthcare encounters, both providers and researchers can learn a great deal from these interpersonal theories.
The theories noted herein need to be tested further in the healthcare context to fully understand their worth and applicability for advancing the field. In a sense, the healthcare context itself almost serves to violate some of the assumed principles of some of these theories. Originally, these theories have often been used in personal relationships where we might expect a more similar power balance; power imbalance may be seen more often in the healthcare context. Although these theories are both useful and applicable in the healthcare communication context, they may need to be molded to fit this unique situation.
Conclusion This manuscript presented nine selected interpersonal theories relevant to the practice of healthcare and the provider-patient relationship. In the past these theories have been used to describe and explain interpersonal relationships such as friendships, romantic relationships, marital relationships, and familial relationships.
Some theories have been used in the healthcare context to explain self-disclosure, goal creation and accommodation.
Practice Implications This article serves as an introductory primer to theories of interpersonal communication that have been or could be applied to healthcare communication research. Understanding key constructs and general formulations of these theories may offer providers additional theoretical frameworks to improve healthcare communication. Providers may find it useful to consider these theories when problem-solving a difficult interaction with a patient or to consider the theories more generally as part of a self-reflective learning process.
Acknowledgments The authors wish to thank Richard L. This is a PDF file of an unedited manuscript that has been accepted for publication.
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Houghton Mifflin Company; A practitioner's guide to persuasion: An overview of 15 selected persuasion theories, models and frameworks. Patient Education and Counseling.
Primary and secondary goals in the production of interpersonal influence messages. A goal-driven model of interpersonal influence. The production of interpersonal influence messages. Goals-plans-action theory of message production: Developing theories of persuasive message production: Advances in communication theory. The handbook of interpersonal communication. Attaining goals through communicative action. Communication goals and plans. Family communication about genetics.How to Maintain Good Relationships : Attraction Theory
Patients' reasons for refraining from discussing internet health information with their health care providers. Enabling patients and physicians to pursue multiple goals in health care encounters: Describing a new conceptual model. Some explorations in initial interaction and beyond: Toward a development theory of interpersonal communication.
Managing uncertainty about illness: Health care providers as credible authorities. Applied Interpersonal Communication Matters: Communicating under conditons of ambiguity. Communication and uncertainty management. The patient self-advocacy scale: Measuring patient involvement in health care decision-making interactions.
Communication in the management of uncertainty: Basic and Applied Psychology. Communication and problematic integration in end-of-life decisions: Dialysis decisions among the elderly. Coping with uncertainties in advance care planning. From coping with life to coping with death: Problematic Integration for the seriously ill elderly.
Spontaneous causal searching and adjustment to abnormal Papicalaou test results. Faith, hope and charity: An in-depth interview study of cancer patients' information needs and information-seeking behavior. Western Journal of Medicine. From "reducing" to "coping with" uncertainty: Reducing uncertainty through communication during adjustment to disability.
Handbook of communication and people with disabilities: A cognitive approach to human communication: An action assembly theory. Greene JO, Geddes D. An action assembly perspective on social skill. Formulating and producing verbal and nonverbal messages: Contemporary theories and exemplars. Lawrence Erlbaum Associates, Inc; Communication in medical encounters: Handbook of Health Communication. Lawrence Erlbaum Associates; Perspectives, Processes, and Contexts.
The McGraw-Hill Companies; Accommodation in medical consultations. Cambridge University Press; Intergroup communication between hospital doctors: Implications for quality of patient care. Watson B, Gallois C. Nurturing communication by health professionals toward patients: A Communication Accommodation Theory approach. Initial application and evaluation. An analysis of ritual elements in social interaction. Essays on Face-to-Face Behavior.
Brown P, Levinson S. Some universals in language use. Bylund CL, Makoul G. Empathic communication and gender in the physician-patient encounter. Provider-patient dialogue about internet information: An exploration of strategies to improve the provider-patient relationship.
Doctor-patient communication about cancer-related internet information. Journal of Psychosocial Oncology. Face and politeness in pharmacist-physician interaction. Confrontation and politeness strategies in physician-patient interactions.