Ch 5- Therapeutic Use of Self

Which of the following is not considered a part of body language?

• Mannerisms

• Speech

• Posture

• Position

Answer explanation

Body language may be one of the first ways that children and families relate to occupational therapists.  This refers to how one positions his/her body in relation to another (for example, the distance when first meeting versus after establishing a close relationship).  It includes one’s posture, mannerisms, movement, eye contact, and touch (Taylor, 2008).

What is the last step in interpersonal reasoning?

• Choose a response mode or mode sequence

• Gather feedback

• Anticipate

• Determine if a mode shift is required

Answer explanation

The six steps of interpersonal reasoning include:

· Anticipate· Identify and cope

· Determine if a mode shift is required

· Choose a response mode or mode sequence

· Draw upon any relevant interpersonal skills associated with the mode(s)

· Gather feedback

(Taylor, 2008, p. 138)

Mary (the OT) is excited to work with the family of a friend with whom she has lost contact.  Mary hopes the family will be able to connect her with her friend and is looking forward to hearing about her friend.  St the next session, she asks the mother many questions about her friend and they spend a lot of time discussing their home town, etc. Which statement describes this scenario?

• It is not therapeutic: The relationship serves no purpose.

• It is therapeutic: Therapist, child and family have a reciprocal caring relationship.

• It is not therapeutic: Mary is benefiting, but not the child and family.

• It is therapeutic:  Both parties are benefiting in the relationship.

Answer explanation

A therapeutic relationship differs from other relationships in that it is designed to benefit the child and family (not the therapist) (Taylor, 2008).  While occupational therapists gain a sense of accomplishment and achievement when children and families succeed, the therapeutic relationship addresses the child’s and family’s needs and goals.

Kasey, the occupational therapist, meets with the principal of the school to see if it is possible to change the cafeteria to better accommodate to her client who has difficulty eating in the noisy and distracting cafeteria.  She brings in stories, research and ideas of how to rearrange things to better meet the child’s needs.  What type of mode best describes Kasey’s approach?

• Collaborating

• Instructing

• Advocating

• Encouraging

Answer explanation

Advocating mode involves ensuring that children and families have access to those resources, materials, and services they need, including transportation, housing, and participation in leisure, work, school and community occupations (Taylor, 2008).  Occupational therapists who use advocacy mode have a deep understanding of children and families’ rights, including laws that provide services and resources.  They evaluate perceived and real barriers for children and their families and support families in removing environmental barriers.  For example, an occupational therapist using advocating mode may write letters justifying community accommodations and seek out grants to support the accommodations.  They may become involved in creating accessible playgrounds or an adaptive ball park.  In school systems, occupational therapists who use advocating mode are likely to understand federal laws and seek services for children under these laws.  They are likely to understand parents’ rights and inform others regarding possible services for children.

Ava  is a 6 year old girl with spina bifida who is generally happy to be at occupational therapy.  On this day, she comes to therapy looking sad and tearful.   She tells the therapist that she had a fight with her best friend at recess. What type of characteristic is described in this scenario?

• Mode change

• Social

• Enduring

• Situational

Answer explanation

Situational characteristics refer to emotional responses to a specific event (situation).  In this case, the child or family responds in an atypical manner to an event in a way that reveals something.  For example, a generally cooperative child may burst into tears when asked about the school day. This is a likely signal that something occurred at school that has the child feeling sad, anxious, or stressed.  As the occupational therapist explores this more, the child reveals that many “small” things occurred leading up to this event and he is need of support. Situational characteristics for families may involve changes in the child’s status, medical condition, or family events.  Parents of young children may get less sleep which overtime can cause stress, irritability, and quick responses to inquiries.  Situational characteristics may include feelings of loss and parents may present as sad, irritable, anxious, insecure or angry (Taylor, 2008).