The problem addressed through this study was that the combination of student anxiety towards patients with mental health conditions along with their unpreparedness for exercising active listening, empathy, and self-awareness in clinical situations created a barrier to achieving therapeutic nurse-patient relationships in Psychiatric-Mental Health Nursing. The purpose of this quantitative quasi-experimental study with a one-group pretest-posttest design was to examine if participation in a Communication Simulation Lab was associated with decreased anxiety and improved active listening, empathy, and self-awareness in a sample of baccalaureate nursing students. The National League for Nursing Jeffries simulation theory, the theory of client-centered therapy, and the theory of interpersonal relations in nursing served as the theoretical framework for the study. The research questions focused on whether the intervention was associated with differences in the students' levels of anxiety, active listening, empathy, and self-awareness. A convenience sample of 89 senior-level baccalaureate nursing students participated in the study. Data analysis via one-sided paired-samples t-tests revealed that students felt a significant change in their levels of anxiety (p < 0.001) and active listening (p < 0.001), and unchanged empathy and self-awareness levels after completing the simulation. Implications of the study include support for the use of low-fidelity simulations to prepare students for psychiatric nursing. Recommendations for practice include connecting simulation fidelity to learning objectives, using role-play simulations to prepare students for psychiatric clinicals, and implementing role-play simulations for communication skills training. Future research should address the following areas: long-term benefits related to the intervention, the objective reality of students' clinical practice, multisite testing, addressing student empathy levels, and targeting self-awareness levels in nursing practice. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]