Therapeutic Modes               Gregorio, L.M.                Maximo, B.K.        USTH-CC Interns, 2013
 INTRODUCTION    6   THERAPEUTIC MODES     ◦ advocating,     ◦ collaborating,     ◦ empathizing,     ◦ encouraging     ◦...
 Personalities are comprised of a unique  set of emotional experiences, a distinct  pattern of interpersonal behavior, an...
Genetics,      +   Biology      + ExperiencesTEMPERAMENT
 personality and temperament do not  change significantly over the life span  (Kagan, 2000) how we relate to others dail...
   a specific way of relating to a clientTherapeutic Modes
 reflected in (a) her fundamental  motivation to serve others, (b) her  preferred approach to serving, and (c) the  value...
   Optimal therapy = flexibility of OT    ◦ develop an awareness of her natural modes    ◦ develop the self-discipline to...
◦ advocating, ◦ collaborating, ◦ empathizing, ◦ encouraging ◦ instructing ◦ problem solvingTHERAPEUTIC MODES
   Negative effects    ◦ Too frequently or inflexibly,    ◦ When the timing is not right for the client,    ◦ When the mo...
Advocating Mode
Optimally               FunctionalOccupational       Social   Physical
   Provide clients with vital resources   Approach interpersonal difficulties by    adjusting and accommodating to the  ...
   Become involved in civil rights or legal    activities in behalf of their client   Consciousness-raising about their ...
If therapists do not advocate for their clients, they would be on their own to battle insurance companies, agencies that p...
   Underestimating the capabilities of the    client, making them feel powerless but    who is actually capable of becomi...
Collaborating Mode
   Makes decisions jointly with the client   Involve clients in reasoning   Solicit ongoing feedback from clients   Em...
   This mode reflects many of the core    values of occupational therapy.   These values are enabled by having    client...
   This mode is likely to instill confidence    in clients    ◦ because it conveys the idea that therapists      view the...
   Overreliance on this style or using it non-    judiciously across all types of clients   May not be received well by ...
   Clients may be looking for a structured    instruction, advice, resources and ongoing    direction   Therapists who v...
   Unrestrained or unstructured    collaboration may result in diffusion of    responsibility or uncertainty regarding   ...
   Clients may become lost, insecure,    and/or anxious about the therapy    process when they are asked to    participat...
Empathizing Mode
   Bearing witness and to fully understand    a client’s    physical, psychological, interpersonal, and    emotional expe...
   OTs listen carefully are watchful of what    their client’s communicate and adjust    their approach accordingly   Us...
   Provides a model for the clients to learn    to empathize with themselves and to    self-reflect and gain insight into...
   Empathizing tends to disarm clients who    are reluctant, resistant, critical or    otherwise negativistic about thera...
   Slow pace of this mode may be    beneficial to clients not yet ready to    engage in OT   Overemphasis can place too ...
   Some clients may not be ready to see    or hear emotions reflected back to    them. Instead feel more comfortable    f...
   Therapists who show too much emotion or    probe too much for emotional expression    from client may be perceived as ...
   Clients may perceive the therapist as a    friend, and become disappointed and    rejected when the therapist does not...
Encouraging Mode
 therapist works to instill clients with hope,  courage, and the will to explore or  perform a given activity “cheerlead...
 open and generous in their emotional  expression, project a great deal of  positive energy, skilled at conveying  optimi...
 anxious, demoralized or reluctant  participants convey their belief in a client’s  potential for successStrengths of En...
 Clients may be desensitized to its  use overtime Clients may develop have difficulty  in developing a sense of intrinsi...
Instructing Mode
 Therapists emphasize education assume a teaching style providing detailed descriptions of the  objectives and tasks of...
 provide  their clients with  information, direction,  recommendations, and in some  circumstances, advice Instructional...
 excellent  teachers and clear  communicators empower and inspire their  clients by ◦ sharing information ◦ noting accom...
 Therapist  may overinvest = react  more negatively when they cannot  get clients to do what they would  like them to do...
 Clients may misunderstand therapist’s  behavior as being parental,  authoritarian, dominant, controlling, or  demanding...
 Therapists rely heavily on using  reason and logic in their  relationships with clients have excellent technical abilti...
 Therapists  are self-sufficient, self-  disciplined, and straightforward in  their communications, and  solution-oriente...
 Therapists may be vulnerable to  assuming an expert stance or a  more challenging approach without  paying enough attent...
 unwitting use of technical terms and  language in inappropriate settings Therapist as aloof, judgmental or  distant by ...
   No single “typical” manner in which a    therapist might enact a mode or set of    modes   Modes may be used intercha...
   In shifting modes make sure that the two    modes are easily distinguished        “I understand why you want to use   ...
1.   Think about what message you believe     the client needs to hear at that moment1.   Occasionally remind yourself why...
   is a skill set that incorporates the    therapeutic modes they view as being    maximally therapeutic for their client...
No therapist is perfect!
THANK YOU! 
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Therapeutic Modes - My Part

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  • Disability is a function of environmental barriers rather than client impairments
  • Vital resources that ensure physical mobility and access, socialization, equal participation, and appropriate work or educational opportunities
  • Social or cultural networks with hierarchical role- looking for structured instructions, advice, resources, and ongoing direction Overvaluing may lead to the therapist misunderstanding or misperceiving less-engaged clients as being passive or even apathetic when these clients are merely behaving within their own sociocultural comfort zone. If does not identify and examine this discrepancy would lead the therapist to become disappointed Client’s from culture that view the patient-provider relationship in a more hierarchical fashion may mis-perceive the therapist as lacking expertise There are times when clients need more directive therapy to feel a sense of psychological security and emotional stability Asking clients to collaborate before they are ready causes the client to feel confused, lost, insecure and/or anxious
  • This weakens the intended message and affects the therapist’s influence
  • Therapeutic Modes - My Part

    1. 1. Therapeutic Modes Gregorio, L.M. Maximo, B.K. USTH-CC Interns, 2013
    2. 2.  INTRODUCTION 6 THERAPEUTIC MODES ◦ advocating, ◦ collaborating, ◦ empathizing, ◦ encouraging ◦ instructing ◦ problem solving  SUMMARYOUTLINE
    3. 3.  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 communityINTRODUCTION
    4. 4. Genetics, + Biology + ExperiencesTEMPERAMENT
    5. 5.  personality and temperament do not change significantly over the life span (Kagan, 2000) how we relate to others daily vary interpersonal strategies
    6. 6.  a specific way of relating to a clientTherapeutic Modes
    7. 7.  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.Therapist’s Personality
    8. 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. 9. ◦ advocating, ◦ collaborating, ◦ empathizing, ◦ encouraging ◦ instructing ◦ problem solvingTHERAPEUTIC MODES
    10. 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. 11. Advocating Mode
    12. 12. Optimally FunctionalOccupational Social Physical
    13. 13.  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 justiceOT as an advocate
    14. 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. 15. 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.Strength of Advocating Mode
    16. 16.  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 independenceCautions of Advocating Mode
    17. 17. Collaborating Mode
    18. 18.  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 independenceOT as a collaborator
    19. 19.  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 performanceStrengths of Collaborating Mode
    20. 20.  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 livesStrength of Collaborating Mode
    21. 21.  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 therapyCautions for Collaborating mode
    22. 22.  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 disappointedCaution for Collaborating Mode
    23. 23.  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 therapyCaution for Collaborating Mode
    24. 24.  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 readyCaution for Collaborating Mode
    25. 25. Empathizing Mode
    26. 26.  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 behaviorOT as an empathizer
    27. 27.  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 conflictsOT as an empathizer
    28. 28.  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 therapyStrengths of Empathizing Mode
    29. 29.  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 relationshipStrengths of Empathizing Mode
    30. 30.  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 therapyCaution for Empathizing Mode
    31. 31.  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 unaccomplishedCaution for Empathizing Mode
    32. 32.  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 clientsCaution for Empathizing Mode
    33. 33.  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 outCaution for Empathizing Mode
    34. 34. Encouraging Mode
    35. 35.  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 engagementEncouraging Mode
    36. 36.  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 = childrenStrengths of Encouraging Mode
    37. 37.  anxious, demoralized or reluctant participants convey their belief in a client’s potential for successStrengths of Encouraging Mode
    38. 38.  Clients may be desensitized to its use overtime Clients may develop have difficulty in developing a sense of intrinsic motivation independently Risk of being misinterpretedCautions of Encouraging Mode
    39. 39. Instructing Mode
    40. 40.  Therapists emphasize education assume a teaching style providing detailed descriptions of the objectives and tasks of therapy providing feedback to clients about the therapy processInstructing Mode
    41. 41.  provide their clients with information, direction, recommendations, and in some circumstances, advice Instructional statements and mini- lectures, role modeling and demonstrations Q and AInstructing Mode
    42. 42.  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 participationStrengths of Instructing Mode
    43. 43.  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 therapyCautions of Instructing Mode
    44. 44.  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 themCautions of Instructing Mode
    45. 45.  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 approachesProblem-Solving Mode
    46. 46.  Therapists are self-sufficient, self- disciplined, and straightforward in their communications, and solution-oriented clients who are uncomfortable with a more emotion-focused approachStrengths of Problem-SolvingMode
    47. 47.  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 intimidatingCautions of Instructing Mode
    48. 48.  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 demandingCautions of Instructing Mode
    49. 49.  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 communicationModes in Perspective
    50. 50.  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”Modes in Perspective
    51. 51. 1. Think about what message you believe the client needs to hear at that moment1. Occasionally remind yourself why it is therapeutic for the client to hear the given message1. Take responsibility for what you saySuggestions to ensure that modesare used purely
    52. 52.  is a skill set that incorporates the therapeutic modes they view as being maximally therapeutic for their clientsTherapeutic Style
    53. 53. No therapist is perfect!
    54. 54. THANK YOU! 
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