quiz 3

taylor ch 7-11

therapeutic responding

encourages therapists to be systematic and self-disciplined when deciding what to say, do, and express to clients when facing a sensitive or negative situation.

suboptimal responding

ultimately lead clients to feel devalued, hurt, judged, defensive, belittled, neglected, or emotionally abandoned.

interpersonal reasoning

process by which a therapist monitors the interpersonal events of therapy, the client’s unique interpersonal characteristics, and her or his own communication in a refective way.

steps of interpersonal reasoning

1. anticipate

2. identify and cope

3. determine if a mode shift is required

4. choose a response mode or mode sequence

5. draw upon any relevant interpersonal skills associated with the mode(s)

6. gather feedback, and if necessary, strive toward mutual understanding of the response

mode shift

intentional change in the way a therapist relates to a client

interpersonal event cascade

when more than one interpersonal event occurs during a single interaction

response mode sequence

When a therapist shifts modes rapidly to address a single interpersonal event or sequence of interpersonal events

interpersonal event

inevitable, naturally occuring communications, reactions, processes, tasks, or general circumstances that take place within the context of the client-therapist interaction

interpersonal event categories

expression of strong emotion, intimate self-disclosure, power dilemmas, nonverbal cues, verbal innuendos, crisis points, resistance and reluctance, boundary testing, empathic breaks, emotionally charged therapy tasks and situations, limitations of therapy, contextual inconsistencies

therapeutic communication

aspects of communication that comprise the interpersonal skill category

• verbal communication, nonverbal communication, unidirectional/bidirectional communication, therapeutic listening, seeking and responding to client feedback, providing clients with structure/direction/feedback

verbal communication

the use of a formally recognized spoken or signed language.

emotional modulation

therapists should be aware of and adjust the level of emotion present in their tone and choice of words to the situation at hand and the client’s preference.

unidirectional communication

communication that does not feel reciprocal to the therapist because it is initiated and sustained by the therapist without any apparent response from the client.

bidirectional communication

communication that feels reciprocal to the therapist because, at a minimum,

it involves some indication that the client has received the communication.

therapeutic listening

involves the therapist’s efforts to gather information from a client in such a way that it promotes greater understanding of the client’s experience.

• empathic listening, guided listening, verbal prompts and sounds, enrichment questions

empathic listening

involves the process of recounting, accepting, and affrming any perception or experience a client offers

guided listening

alternative approach that involves a therapist’s attempts to shape what the client is saying by making one or more summary-type statements that serve to clarify or organize what a client has said.

verbal prompts and sounds

These utterances may be used to remind a client that you are listening, highlight something a client has just said, or encourage a client to say more.

enrichment questions

gentle forms of inquiry designed to encourage a client to continue to communicate or to enrich what is being described.

rapport building

one’s deliberate overtures to make a client feel at ease, particularly when frst meeting and getting to know the client.

impression management

deliberate behaviors and statements that prepare the client to begin to trust in your personal and professional integrity.

mode matching

therapist’s commonsense efforts to select a mode that is most likely to be coherent with the client’s interpersonal needs of the day or preferred way of approaching the therapeutic relationship.

mode versatility

describes the process of trial and error undertaken by a therapist when

shifting modes. The aim of this trial-and-error process is ultimately to identify the best-fit mode for the client at that moment in time.

approaches to managing emotional intensity

• Witnessing the client’s expression (without use of language)

• Showing emotional resonance (feeling the same type of emotion as the client and allowing your feelings to show it through your affect or in what you say)

• Labeling the client’s affect or emotional expression

• Intervening in the emotional expression

judicious use of touch

knowing how to use touch in a way that respects clients’ boundaries and meets

their interpersonal needs—whether they be for closeness or for distance

semi-structured interview

therapist follows a pre-determined protocol and asks a set of questions designed to probe for a specifc kind of information.

open-ended interview

questions are formulated more spontaneously and as needed

strategic questioning

asking clients questions in a way that intends to infuence their perspective, convey a certain message, or cause them to refect upon and evaluate their thinking about a given topic.

origin or source questions

How did you first get the idea that [you will not be able to work again]? Does

your doctor feel otherwise? What has led you to believe that [you won’t find

accessible housing outside the city]?

questions that probe evidence

What do you already know that supports your idea that [your friends think that you complain too much]? Do you believe this constitutes enough evidence? Are there any alternative explanations [that you are having more difficulty today]? What evidence do you have that [you are not recovering quickly enough]?

questions that probe assumptions

Let’s assume for the moment that your belief [that your boyfriend no longer

finds you physically attractive] is true. What does this say about you? What

does that say about your boyfriend?

To conclude that [you will never be able to think as clearly as you once did],

what must you assume? Do you think someone else would make this same

assumption?

questions about viewpoint

It sounds as if you believe that you are being punished for [your affair]. Why

have you chosen to explain [your accident] from this perspective?

How might someone else who [has had an affair] explain the fact that she

also survived [an accident]? How might a friend have interpreted [the physical

therapist’s behavior]? Would your partner look at this in the same way?

questions about consequences

If you decide not to [complete your rehabilitation goals], what positive

consequences might be involved? What negative consequences might be

involved?

What are the likely short-term consequences of [not wearing your splint

when you go to bed]? What long-term consequences might be involved?

dynamic

defines the distinctive quality, emotional tone, and specific interpersonal events that comprise an interaction between individuals

emotional dynamic

unspoken communication occuring between the therapist and client

emotional bouy

how an OT supports a client and their emotions

scapegoating

when individuals collude to influence, criticize, reprimand, subjugate, shame, punish, or otherwise control another individual