Therapeutic Communication Interactive Reasoning. C OMMUNICATION IN G ENERAL

Therapeutic Communication

Interactive Reasoning

COMMUNICATION IN GENERAL

Tools of the Trade Body Language Listening Questions Leads & Responses

Body Language Relax! Smile Arms open Mirror the client Good eye contact Sit STILL!!

Affect Allow your affect to

reflect your response, but avoid judging, disgust, shock!

Listening Goals Self-perception Perception of others Perception of how others view

them Main concerns Perception of therapy Goals Defenses and coping Values

Questions? Implies authority to ask questions and that

you will have a solution! Will this inhibit the flow?

Open ended Questions You felt great after the game, didn’t you? You don’t seem yourself today. Anything

wrong? Do you want to learn transfers? Do you like school? Your little sister is adorable, isn’t she? Don’t you think this is a great idea?

Indirect Questions How do you like your new job? vs. I wonder what you think of your new job.

How does the new splint feel? What are you feeling right now? How did that make you feel?

One at a time please Do you want to come tomorrow or the

next day?

How are those exercise working for you? Have you had any pain?

How will you handle to ride to work and the steps up to your office?

When to ask questions Confused, need clarification

So you are saying that if is hard to move in the morning, is that right?

Need specific informationWhat makes the pain worse?

Guide the conversationWhat gets in the way of getting what you want done in the morning?

Verbal Tools Reflecting &

paraphrasing Clarifying Minimal encouragers Summarizing Linking Self- disclosure

What do I say next?! What do

I say next?! Think, Think, Aggh, I can’t

think of anything!

Simple Responses Silence! Mmmm (minimal encourager) Restatement Clarification

Higher level responsesReflection- provide a mirror to attitudes

and feelings

“Because I’m a no good drunk, I wasn’t there for my kids.”

“I don’t belong here, everyone here is crazy.”

“I can’t work, I just don’t get along with people. They always pick on me.”

LeadsInterpretation Proceed with caution! State as tentative Only when the client is about to realize it

themselves

“You find it hard to think of yourself as disabled in some way”

Ok but not too much Encouragement- can be patronizingBetter: provide structured tasks that

naturally reward

Reassurance- only tell the truth, sometimes a hug is better

Suggestions- only as options, never tell them what to do. Avoid the yes, but syndrome

Never use Advice Urging Moralizing Criticism Direct disagreement Denial or disbelief Demand or blackmail

What is the single most important tool that students forget

to use?

SILENCE!

Interrogation vs. Interview Open ended questions Allow for silence Avoid interrupting client Client talks more than you Avoid jargon Don’t write everything down!

INITIAL INTERVIEW

Physical Arrangement Two chairs Avoid table b/w Always sit by the door Door open or closed? QUIET! no cell phone Private Clip board to take

notes

Stages1. Introduction2. Exploration3. Closure

Stages: Introduction (Big 5)1. Introduce yourself2. Ask permission or thank client for time3. State purpose of interview 4. State time frame5. Explain limits of confidentiality

Open ended start: “Tell me a little bit about yourself.”

Introduction: Memorize! Hi, my name is Robin Steed. I’m an

occupational therapy student from LSU. I’d like to talk to you for about 10 minutes about your therapy/work here so that I can learn how to interview people. Everything we say here is confidential, unless you tell me that you are planning to hurt yourself or someone else.

Stages: Exploration Open ended questions

Keep areas of needed info in mind, not specific questions

If appropriate, allow client to see your notes

Stages: Closure Well, it looks like we’re about out of time. We’ve talked about your work and your

schedule and the changes you’d like to make.

Do you have any questions for me? Thank you for talking with me today. (Shake hands if appropriate.)

Wear LSU Polo Shirts for VOH

Kakis, no jeansConservativeComfortableStretchyLoose fittingAthletic shoes okNo sandals