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Therapeutic Communication

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.

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Therapeutic Communication

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  1. Therapeutic Communication Interactive Reasoning

  2. Communication in General

  3. Tools of the Trade • Body Language • Listening • Questions • Leads & Responses

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

  5. Affect • Allow your affect to reflect your response, but avoid judging, disgust, shock!

  6. Listening Goals • Self-perception • Perception of others • Perception of how others view them • Main concerns • Perception of therapy • Goals • Defenses and coping • Values

  7. Questions? • Implies authority to ask questions and that you will have a solution! • Will this inhibit the flow?

  8. 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?

  9. 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?

  10. 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?

  11. 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?

  12. Verbal Tools What do I say next?! What do I say next?! Think, Think, Aggh, I can’t think of anything! • Reflecting & paraphrasing • Clarifying • Minimal encouragers • Summarizing • Linking • Self- disclosure

  13. Simple Responses • Silence! • Mmmm (minimal encourager) • Restatement • Clarification

  14. 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.”

  15. 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”

  16. 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

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

  18. What is the single most important tool that students forget to use? SILENCE!

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

  20. Initial Interview

  21. 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

  22. Stages • Introduction • Exploration • Closure

  23. Stages: Introduction (Big 5) • Introduce yourself • Ask permission or thank client for time • State purpose of interview • State time frame • Explain limits of confidentiality • Open ended start: “Tell me a little bit about yourself.”

  24. 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.

  25. Stages: Exploration • Open ended questions • Keep areas of needed info in mind, not specific questions • If appropriate, allow client to see your notes

  26. 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.)

  27. Wear LSU Polo Shirts for VOH Kakis, no jeans Conservative Comfortable Stretchy Loose fitting Athletic shoes ok No sandals

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