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