Communication is defined as the giving and receiving of messages or, perhaps more appropriately, the exchange of meaning producing mutual understanding (O'Toole, 2012), The mutual exchange of information is inherent to effective communication and involves reciprocity and a two-way process of sharing information. This requires a common language that is m0re than just words, and includes emotions, behaviour, symbols and signs, Further, information that is shared needs to be both accurate and authentic to move towards shared understanding (Lucock, Lefevre, Orr et al., 2006, p. 3). Communicating with children and young people offers unique challenges in achieving shared understanding, Differences in age, gender, socio-cultural experiences and personal assumptions can impact on the development of shared understanding, For example, ineffective communication with a child could result from the nurse using language the child does not yet understand. Fear and mistrust can also prevent shared understanding so it is essential that the child's fears are acknowledged and alleviated.

It is important that communication with children, young people and families is based on fundamental skills of good communication technique, developing mutual understanding and a therapeutic relationship. Stein-Parbury (2009, pp. 52-53) outlines how communication competence is based on a therapeutic use of self and a balance between responsiveness (being able to listen to and understand others) and assertiveness (being able to express yourself). The reader is referred to both the O'Toole (2012) and Stein-Parbury (2009) texts for further details on developing fundamental communication skills and a therapeutic relationship. This chapter will help build your skills in forrn.ing therapeutic relationships with children, young people and their families through developing:

1. a style of communication - positive commumcation for health professionals - that is strengths-based, promotes a solution focus and can help strengthen nurse-child-family relationships
2. family assessment skills.