OT 402 - client-centered groups

complexity theory

agents within a system interact to produce behavior; behavior cannot be predicted (but there are patterns)

clinical reasoning

professional reasoning; involves application of multiple perspectives

"three-track mind"

1. procedural

2. interactive

3. conditional

procedural mindset

therapist solves problems with everyday occupations

interactive mindset

therapist connects with people

conditional mindset

therapist engages in metacognitive process

five dimensions of reasoning

1. scientific

2. narrative

3. pragmatic

4. ethical reasoning

5. interactive and conditional reasoning

scientific reasoning

procedural reasoning, scientific knowledge

narrative reasoning

client's subjective experience

pragmatic reasoning

practical considerations (i.e., timing, location, funding)

ethical reasoning

values and judgments

interactive and conditional reasoning

relationship-building and preparing for changes

canadian models

1980 - quality assurance guidelines for health professions

1983 - canadian model of occupational performance (CMOP)

2007 - canadian model of occupational performance and engagement (CMOP-E)

2022 - canadian model of occupational participation (CanMOP)

CMOP

focus on interaction between person, environment, and occupation resulting in performance

CMOP-E

expands on CMOP to include client's ability to choose and complete desired activities (engagement)

CanMOP

participation = having access to, initiating, and sustaining valued occupations within meaningful relationships and contexts

existential concepts

concerned with human existence; emphasis on client's perspective of the world

existentialism - key concepts

- freedom and responsibility

- aloneness and relatedness

- existential anxiety and search for meaning

freedom and responsibility (existential concepts)

OT groups promote self-awareness, environmental awareness, and choices

aloneness and relatedness (existential concepts)

- finding own identity and forming interpersonal relationships with others

- OT groups promote socialization skills

existential anxiety and search for meaning (existential concepts)

- anxiety is necessary; no intrinsic pre-determined meaning

- OT groups can help distinguish one's values and worldviews

humanistic concepts

allows clients to choose direction of therapy (set goals, provide solutions, etc.)

humanism - key concepts

- respect

- genuineness

- non-judgmental acceptance

- deep understanding

- self-actualization

- occupational competence and motivation

- spirituality

- cultural competence/humility

therapeutic use of self

- forming and maintaining therapeutic relationships

- characterized by collaboration, communication, empathy, and mutual understanding

intentional relationship model - therapeutic modes

- advocating

- collaborating

- empathizing

- encouraging

- instructing

- problem-solving

therapeutic use of self - stage I

problem definition; similar to "forming" stage

therapeutic use of self - stage I skills

- attending

- concreteness

- primary accurate empathy (PAE)

attending (stage I skill)

- physical presence; focus on the client

- form impressions about participants to make predictions

concreteness (stage I skill)

- ability to elicit info about a client or problem

- use open-ended questions

primary accurate empathy (stage I skill)

reflect what the client is feeling or the content they are expressing; let's the client know they are being listened to and understood; encourages self-disclosure

therapeutic use of self - stage II

self-understanding

therapeutic use of self - stage II skills

- advanced accurate empathy (AAE)

- confrontation

- immediacy

- therapist self-disclosure

advanced accurate empathy (stage II skill)

make clients more aware of hidden feelings and help them see patterns

confrontation (stage II skill)

- resolution of strategies clients use to avoid self-understanding and behavior change

- develop new skills and gain resources

- point out maladaptive behaviors and leave judgment of behaviors up to the client

immediacy (stage II skill)

- direct mutual communication

- processing the relationship (typically troubled in this stage)

- ask questions that allow the clients to reflect on their own feelings

therapist self-disclosure (stage II skill)

- sharing personal stories or experiences with the client

- help provide greater awareness and understanding of the situation

indirect self-disclosure

- nodding

- smiling

- frowning

- weight-shifting

direct self-disclosure

verbally revealing and describing strategies used

therapeutic use of self - stage III

behavior change

behavior change (stage III skill)

facilitate lifestyle changes in habits, routines, and relationships to maximize the client's new performance capacities and to improve volition and personal causation