Chapter 16 Therapeutic Relationships intro to OT

Clarification

Client's thoughts and feelings are summarized/simplified. Ex: You came to therapy expecting immediate function/use of arm. Now you realize it may take longer than expected.

focus group

Finds out about the attitudes and opinions of members, a means to investigate a theme, generate research hypotheses or organize discussion around a specific topic.

How do the universal stages of loss relate to our profession? What is the OT practitioner's role?

Kubler-Ross defined the U.S.L as denial, anger, bargaining, depression and acceptance. D.A.B.-D.A. During intervention process, clts. may experience some or all of these stages. OT shows support by being sensitive to the emotional impact of loss. A sensitive OT can make the emotional journey less difficult.

How do therapeutic relationships differ from friendships?

The relationship is not a give and take. The CLIENT should benefit from the relationship.

Group activities may include

cooking, arts and crafts, exercise, ADL's and reality orientation. cooking, arts and crafts, exercise, ADL's and reality orientation.

What should OT do after he/she determines the group goal

decide how to meet INDIVIDUAL needs within group task

intentional relationship mode developed by Taylor... SYSTEMATICALLY

describes therapeutic use of self & the development of MODES of interacting with clts. for client's benefit.

What should a practitioner do prior to leading a group intervention?

determine the individual goals of each member

A practitioner must be aware of

group dynamics: how group members are working together

consultation and supervision groups

group format for PEER support, consultation and supervision of OTAs, aides and caregivers. Increasingly necessary as large OT depts diminish and more practitioners work independently in private and community based practices.

reflection in active listening

hearing the emotion behind the words. OT verbalizes both the CONTENT and IMPLIED FEELINGS ex: You're frustrated and feeling defeated because you can't dress yourself. (hint: reFlection..."F"=feelings implied)

goal of the therapeutic relationship

help clients achieve their desired goal

therapeutic process involves

identifying goals and objectives, developing intervention plan, using interactions to help clients achieve goals

Active listening

listening w/o judgements, or jumping in with advice. Receiver PARAPHRASES the speaker's words to ensure understanding of intended meaning.

Therapeutic Use of Self Principles

1, practitioners must have SELF-AWARENESS, and mindfully examine their role, 2nd, DEVELOP TRUST, and be SUPPORTIVE and ACTIVELY LISTEN and EMPATHIZE. The must be genuine and respectfully, trusting and warm with clients.

list modes/styles of interacting with the client for their benefit

A.C.E. P.I.E. advocating, collaborating, empathizing, problem-solving, instructing, encouraging and problem-solving.

How does the therapeutic relationship affects the success of intervention?

An OT taking interest in the client, talking with them and listening is of great value to the success of intervention.

group dynamics

Group interacting forces. May involve setting limitations on one who takes over the group.

What should the practitioner do after he has determined the group goals?

He organizes the activity by analyzing the steps involved including the number of participants, setting, timing, and materials needed. All group members must work toward their goals.

through careful assessment and interaction

How does the OT select courses of action to benefit the client?

the primary aim of therapeutic groups

INDIVIDUAL change. Therapeutic tasks are designed to restore or develop functioning in occupational performance areas and client factors. May include prevention and support of existing strengths. (usually 6 -10 people)

What should modes be?

Intentional. Therapists need to shift modes as needed.

how does the use of clarification help?

It enables the client to look closer at their thoughts and feelings experienced.

the role & skills required of the OT practitioner

OT begins by taking steps to assess what pt is unable to do and the effectiveness of what pt. is doing. Some pts perform tasks inefficiently, causing frustration and depression. OT will teach pt. how to do activity and what changes needed to complete the activity properly. Once OT has taught them that particular goal, they move onto other areas of interest.

What must you do if a client feels that they have lost control of their life?

OT does not take more of client's sense of control by forcing client into therapy if he is not ready.

Self-awareness:

OT examines his own nature, recognizes their own behavior, emotional responses and affect on other people. Need to know their own strengths, weaknesses and limitations so they can focus on the client.

Explain the psychology of rehab and how it relates to OT.

OT pts. have often sustained catastrophic trauma, illness or emotional disorders. OT addresses PHYSICAL and EMOTIONAL needs of the ct. treating the WHOLE person. OT must understand the client, their motivations, desires and needs, the basis of the therapeutic relationship. Activities must be internally motivating and meaningful to the client to meet the clients goals.

What is wrong with the ideal self?

Perfect self/ideal self (UNREALISTIC) has only desirable qualities and all wants and wishes fulfilled.

therapeutic relationship

The interaction between the OT and the client. It is key for facilitating healing and the rehabilitation process.

Therapeutic use of self:

called the art of relating. It is the process of using one's interactions with the client for the client's benefit. If order for good use of self the OT must be aware of themselves and how they communicate, relate to and present to

non verbal cue from client

client VERBALLY expresses one thought while communicating an entirely different message with facial expression or BODY LANGUAGE.

peer support groups

provide support for individuals who have a diagnosis, medically-related problems or disabilities in common. May involve partners, families and caregivers. small or large group

restatement in active listening

receiver REPEATS the words of client...ex you are angry because your stroke may prevent you from traveling (hint: repeat/restate)

Things to consider in group activities

size and composition group members, client population, FOR, setting, duration and frequency of group meetings.

Examples of individual goals within a group cooking intervention might include

socialization, sharing following steps in a recipe

matching body language

the use of appropriate body mannerisms etc. to match the mood of the situation

categorizes of task groups

therapeutic, peer support, focus and consultation and supervision.

Skills needed by practitioners include

trust, empathy, non verbal and verbal communication, active listening and group leadership skills