Therapeutic Modes - My Part

Some parts of Therapeutic Modes

1. Therapeutic Modes Gregorio, L.M. Maximo, B.K. USTH-CC Interns, 2013

2. OUTLINE INTRODUCTION 6 THERAPEUTIC MODES advocating, collaborating, empathizing, encouraging instructing problem solving SUMMARY

3. INTRODUCTION Personalities are comprised of a unique set of emotional experiences, a distinct pattern of interpersonal behavior, and a stable psychobiological profile (Kagan, 2000). product of genetics, biology and experiences interacting within one’s family and in the broader social community

4. Genetics, + Biology + Experiences TEMPERAMENT

5. personality and temperament do not change significantly over the life span (Kagan, 2000) how we relate to others daily vary interpersonal strategies

6. Therapeutic Modes a specific way of relating to a client

7. Therapist’s Personality reflected in (a) her fundamental motivation to serve others, (b) her preferred approach to serving, and (c) the values she hold while serving reflected through her ways in specific ways in which she behaves and interacts with clients.

8. Optimal therapy = flexibility of OT develop an awareness of her natural modes develop the self-discipline to using the modes be aware of the limits of the modes

9. THERAPEUTIC MODES advocating, collaborating, empathizing, encouraging instructing problem solving

10. Negative effects Too frequently or inflexibly, When the timing is not right for the client, When the mode is not consistent with the client’s personality as a whole, and When the mode is not changed so as to be more consistent with the client’s interpersonal needs of the moment

11. Advocating Mode

12. Physical Optimally Functional Social Occupational

13. OT as an advocate Provide clients with vital resources Approach interpersonal difficulties by adjusting and accommodating to the needs of the client OT becomes a facilitator or defender of justice

14. Become involved in civil rights or legal activities in behalf of their client Consciousness-raising about their legal rights , barriers to access and obstacles to independence Testify on behalf of a client in a legal situation

15. Strength of Advocating Mode If therapists do not advocate for their clients, they would be on their own to battle insurance companies, agencies that provide public or private aid, landlords, educational systems, employers, and other powerful organizations.

16. Cautions of Advocating Mode Underestimating the capabilities of the client, making them feel powerless but who is actually capable of becoming empowered Overestimate a client’s desire, ability and/ resources for autonomy and independence

17. Collaborating Mode

18. OT as a collaborator Makes decisions jointly with the client Involve clients in reasoning Solicit ongoing feedback from clients Empowering the client to use his or her own judgement Encourage autonomy and independence

19. Strengths of Collaborating Mode This mode reflects many of the core values of occupational therapy. These values are enabled by having clients choose activities , have opinions, and participate actively in evaluating the process of therapy and reflecting on their own performance

20. Strength of Collaborating Mode This mode is likely to instill confidence in clients because it conveys the idea that therapists view them as competent in their ability to direct their treatment, choose occupations, and gain greater control in determining the course of their own lives

21. Cautions for Collaborating mode Overreliance on this style or using it non-judiciously across all types of clients May not be received well by clients who are prefer or are accustomed to view service providers are expert Client inclined to participate in social or cultural networks with hierarchical role structures may not value collaboration in therapy

22. Caution for Collaborating Mode Clients may be looking for a structured instruction, advice, resources and ongoing direction Therapists who value the collaborating mode may misperceive or misunderstand less-engaging clients as passive or even apathetic, when clients are merely behaving in their own comfort zone and may become disappointed

23. Caution for Collaborating Mode Unrestrained or unstructured collaboration may result in diffusion of responsibility or uncertainty regarding who is responsible for which part of the therapy process Overestimating the client’s strengths and capacities. Sometimes client’s need a more directive therapy

24. Caution for Collaborating Mode Clients may become lost, insecure, and/or anxious about the therapy process when they are asked to participate in a collaborative therapy session when they are not yet ready

25. Empathizing Mode

26. OT as an empathizer Bearing witness and to fully understand a client’s physical, psychological, interpersonal, and emotional experience Put a significant amount of time and effort into striving to understand a client’s interpersonal needs and perspective Able to notice and respond to the client’s behavior

27. OT as an empathizer OTs listen carefully are watchful of what their client’s communicate and adjust their approach accordingly Use intermissions from “doing” for processing and communicating with clients Using a understanding as a means for resolving rifts, obstacles and conflicts

28. Strengths of Empathizing Mode Provides a model for the clients to learn to empathize with themselves and to self-reflect and gain insight into their emotional reactions and behaviors Empathy is fundamental to the resolution of conflicts, rifts and misunderstanding that occur during therapy

29. Strengths of Empathizing Mode Empathizing tends to disarm clients who are reluctant, resistant, critical or otherwise negativistic about therapy. Clients feel responded to, cared about and respected. More likely to achieve open, honest communication with clients which increases trust and a more stable relationship

30. Caution for Empathizing Mode Slow pace of this mode may be beneficial to clients not yet ready to engage in OT Overemphasis can place too much emotions in the foreground of therapy

31. Caution for Empathizing Mode Some clients may not be ready to see or hear emotions reflected back to them. Instead feel more comfortable focusing on the activity. Pacing of treatment is slow and functional tasks of the therapy may be delayed or left unaccomplished

32. Caution for Empathizing Mode Therapists who show too much emotion or probe too much for emotional expression from client may be perceived as over-involved or psychologically instructive and may recoil because of too much intimacy or emotional intensity Overprotection of clients, inappropriate level of dependence in more vulnerable or isolated clients

33. Caution for Empathizing Mode Clients may perceive the therapist as a friend , and become disappointed and rejected when the therapist does not behave accordingly to their domains For the therapists, emotional over-involvement may result to guilt over the limitations of what at therapist can actually do and result to a burn out

34. Encouraging Mode

35. Encouraging Mode therapist works to instill clients with hope, courage, and the will to explore or perform a given activity “cheerleaders” Help to generate or help sustain a client’s interests in occupational engagement

36. Strengths of Encouraging Mode open and generous in their emotional expression, project a great deal of positive energy, skilled at conveying optimism and hope, and are willing to celebrate and be joyful with their clients Playful = children

37. Strengths of Encouraging Mode anxious, demoralized or reluctant participants convey their belief in a client’s potential for success

38. Cautions of Encouraging Mode Clients may be desensitized to its use overtime Clients may develop have difficulty in developing a sense of intrinsic motivation independently Risk of being misinterpreted

39. Instructing Mode

40. Instructing Mode Therapists emphasize education assume a teaching style providing detailed descriptions of the objectives and tasks of therapy providing feedback to clients about the therapy process

41. Instructing Mode provide their clients with information, direction, recommendations, and in some circumstances, advice Instructional statements and mini-lectures, role modeling and demonstrations Q and A

42. Strengths of Instructing Mode excellent teachers and clear communicators empower and inspire their clients by sharing information noting accomplishments providing contructive feedback training to utilize tools required for adaptation and participation

43. Cautions of Instructing Mode Therapist may overinvest = react more negatively when they cannot get clients to do what they would like them to do Therapist may tend to bolster, overprotect, or overinstruct their clients to prevent them from experiencing failure in therapy

44. Cautions of Instructing Mode Clients may misunderstand therapist’s behavior as being parental, authoritarian, dominant, controlling, or demanding Therapists may feel obligated to help all clients address their difficulties and may miss the point at which client want them to simply listen and validate them

45. Problem-Solving Mode Therapists rely heavily on using reason and logic in their relationships with clients have excellent technical abilties generally approach the interpersonal aspects of therapy by reasoning or by using other logical approaches

46. Strengths of Problem-Solving Mode Therapists are self-sufficient, self-disciplined, and straightforward in their communications, and solution-oriented clients who are uncomfortable with a more emotion-focused approach

47. Cautions of Instructing Mode Therapists may be vulnerable to assuming an expert stance or a more challenging approach without paying enough attention to other interpersonal needs of the client Clients may misinterpret therapist’s behavior as too strategic or even intimidating

48. Cautions of Instructing Mode unwitting use of technical terms and language in inappropriate settings Therapist as aloof, judgmental or distant by clients who are sensitive, vulnerable or are otherwise interpersonally demanding

49. Modes in Perspective No single “typical” manner in which a therapist might enact a mode or set of modes Modes may be used interchangeably provided that they do not blend into one another during a single communication

50. Modes in Perspective In shifting modes make sure that the two modes are easily distinguished “ I understand why you want to use alcohol, but I need to educate you on why you shouldn’t”

51. Suggestions to ensure that modes are used purely Think about what message you believe the client needs to hear at that moment Occasionally remind yourself why it is therapeutic for the client to hear the given message Take responsibility for what you say

52. Therapeutic Style is a skill set that incorporates the therapeutic modes they view as being maximally therapeutic for their clients

53. No therapist is perfect!

54. THANK YOU! 