UNIT II Aspects of Professional Reasoning


does not come prepackaged. It must be created together by occupational therapists and clients. In exploring interactive reasoning, while acknowledging the mutual ity of its two aspects, building partner-relationships and understanding people and their experiences, we begin by discussing therapeutic relationships. Central to therapeutic relationships is the therapeutic use of self . The concept of emotional intelligence (EI) is useful for exploring the notion of using oneself therapeutically. EI identifies five skills that contribute to relationships through managing oneself and understanding and relating to others. This is followed by a discussion of the process of therapeutic relationships. In the second part of the chapter, we turn our attention to using interactive reasoning in practice. MANAGING SELF AND RELATIONSHIPS Developing relationships with clients requires skilled use of self. The concept of “therapeutic use of self” has long been entrenched in the occupational therapy lexicon (Solman & Clouston, 2016). As stated in the Occupational Therapy Prac tice Framework (OTPF), “[a]n integral part of the occupational therapy process is therapeutic use of self, in which occupational therapy practitioners develop and manage their therapeutic relationship with clients by using professional reason ing, empathy, and a client-centered, collaborative approach to service delivery” (American Occupational Therapy Association, 2020, p. 20). Taylor (2020) explained that “therapeutic use of self requires the therapist to strive towards a fundamental understanding of our clients as human beings, at an interpersonal level” (p. 2). These definitions present therapeutic use of self as a process that requires engage ment and reasoning, variously called interactive (Fleming, 1991) and interpersonal reasoning (Taylor, 2020). Therapeutic use of self is an acknowledgment of the influ ential place of the occupational therapist in the therapeutic endeavor. Interactive reasoning requires a deeply personal engagement, as the term therapeutic use of self implies. However, one’s “self” is used in a specific way: an intentional way, one that fosters achievement of client goals and must remain pro fessional. At times, it will be a conscious process, with actions specifically designed to build rapport or develop or maintain relationships with clients. At other times, the process of interactive reasoning will be essentially tacit, without attracting con scious attention. It might form the unconscious background while conscious at tention is directed elsewhere. For instance, an occupational therapist might be consciously planning assessment or intervention while subconsciously engaged in an elegant interactional dance, subtly responding to clients’ changing demeanors. It may also be completely embodied: a reassuring touch, a movement that conveys understanding or care. Emotional Intelligence Interactional reasoning requires deep personal engagement and warrants further exploration of the skills required for using oneself in therapeutic relationships. EI is one concept, with a developing evidence base in psychology, healthcare, educa tion, management, and leadership (McKenna & Mellson, 2013), that illuminates the close association between the self and relationships. EI has five components: the first three are self-management skills and pertain to the occupational therapist, whereas the last two concern managing relationships. Having an accurate aware ness of one’s strengths and weaknesses regarding these five components provides a sound foundation for therapeutic use of self (see Learning Activity 11-2).

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