Some parts of Therapeutic Modes

1. Therapeutic Modes
Gregorio, L.M.
Maximo, B.K.
USTH-CC Interns, 2013

2.  INTRODUCTION
6 THERAPEUTIC MODES
◦ advocating,
◦ collaborating,
◦ empathizing,
◦ encouraging
◦ instructing
◦ problem solving
 SUMMARY
OUTLINE

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 community
INTRODUCTION

4. Genetics,
+
Biology
+
Experiences
TEMPERAMENT

5.  personality and temperament do not
change significantly over the life span
(Kagan, 2000)
 how we relate to others daily vary
 interpersonal strategies

6.  a specific way of relating to a client
Therapeutic Modes

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.  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. ◦ advocating,
◦ collaborating,
◦ empathizing,
◦ encouraging
◦ instructing
◦ problem solving
THERAPEUTIC MODES

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. Advocating Mode

12. Optimally
Functional
Occupational Social Physical

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
justice
OT as an advocate

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. 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.  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
independence
Cautions of Advocating Mode

17. Collaborating Mode

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 independence
OT as a collaborator

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 performance
Strengths of Collaborating Mode

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 lives
Strength of Collaborating Mode

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
therapy
Cautions for Collaborating mode

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 disappointed
Caution for Collaborating Mode

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 therapy
Caution for Collaborating Mode

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 ready
Caution for Collaborating Mode

25. Empathizing Mode

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 behavior
OT as an empathizer

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 conflicts
OT as an empathizer

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
therapy
Strengths of Empathizing Mode

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
relationship
Strengths of Empathizing Mode

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 therapy
Caution for Empathizing Mode

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 unaccomplished
Caution for Empathizing Mode

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 clients
Caution for Empathizing Mode

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 out
Caution for Empathizing Mode

34. Encouraging Mode

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 engagement
Encouraging Mode

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 = children
Strengths of Encouraging Mode

37.  anxious, demoralized or reluctant
participants
 convey their belief in a client’s
potential for success
Strengths of Encouraging Mode

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 misinterpreted
Cautions of Encouraging Mode

39. Instructing Mode

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 process
Instructing Mode

41.  provide their clients with
information, direction,
recommendations, and in some
circumstances, advice
 Instructional statements and mini-
lectures, role modeling and
demonstrations
 Q and A
Instructing Mode

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 participation
Strengths of Instructing Mode

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 therapy
Cautions of Instructing Mode

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 them
Cautions of Instructing Mode

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 approaches
Problem-Solving Mode

46.  Therapists are self-sufficient, self-
disciplined, and straightforward in
their communications, and
solution-oriented
 clients who are uncomfortable with
a more emotion-focused approach
Strengths of Problem-Solving
Mode

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
intimidating
Cautions of Instructing Mode

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 demanding
Cautions of Instructing Mode

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 communication
Modes in Perspective

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. 1. Think about what message you believe
the client needs to hear at that moment
1. Occasionally remind yourself why it is
therapeutic for the client to hear the
given message
1. Take responsibility for what you say
Suggestions to ensure that modes
are used purely

52.  is a skill set that incorporates the
therapeutic modes they view as being
maximally therapeutic for their clients
Therapeutic Style

53. No therapist is perfect!

54. THANK YOU! 