Therapeutic Communication Interactive Reasoning

C OMMUNICATION IN G ENERAL

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 information What makes the pain worse?  Guide the conversation What 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 responses Reflection- 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.”

Leads Interpretation  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 patronizing Better: 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!

I NITIAL I NTERVIEW

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

Stages 1. Introduction 2. Exploration 3. Closure

Stages: Introduction (Big 5) 1. Introduce yourself 2. Ask permission or thank client for time 3. State purpose of interview 4. State time frame 5. 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 jeans Conservative Comfortable Stretchy Loose fitting Athletic shoes ok No sandals