UNIT II Aspects of Professional Reasoning


show that they care and can journey with their clients, giving them confi dence while leading them on uncharted paths. 5. Social skill: Proficiency in managing relationships and building networks, an ability to find common ground and build rapport A therapeutic relationship is a very particular type of relationship. It is not a friendship, although it requires friendliness. It has an inherent power imbalance and people in the role of clients are often vulnerable and depen dent on professionals. Professional codes of ethics acknowledge this power imbalance and protect vulnerable clients by prohibiting relationships that abuse this position of power. The concept of therapeutic use of self expresses both the permission and the imperative to use one’s social skills for thera peutic purposes. EI emphasizes both personal skills and skills required for relationships, all essen tial aspects of interactive reasoning. However, interactive reasoning involves much more than EI. It is a dynamic process of reasoning about and through relationships. We now move from consideration of “self” and turn to an exploration of relationships, their importance, and key issues relating to developing and maintaining them. Developing and Maintaining Therapeutic Relationships In occupational therapy, effective therapeutic interaction is underpinned by trust ing relationships strengthened through the fulfillment of mutual expectations. Building therapeutic relationships is a pillar of best practice in all clinical settings and contexts. Even in situations where short-term client contact is typical (e.g., acute care settings), time spent purposefully building an understanding of clients’ ideas, priorities, and beliefs and promoting their trust and confidence is important for relationship building. A secure therapeutic relationship provides a solid foun dation for occupational therapy practice and forms the basis for the partnership that is fundamental to interactive reasoning. The term therapeutic relationship refers to the interpersonal relationships be tween health professionals and their clients. Other terms used for this concept are therapeutic alliance, helping relationship, working alliance, and therapeutic rap port (Evatt & Scanlan, 2022). Therapeutic relationships involve “a trusting connec tion and rapport established between therapist and client through collaboration, communication, therapist empathy and mutual understanding and respect” (Cole & McLean, 2003, pp. 33–34). This depiction both defines therapeutic relationships and indicates how they are developed. Common attributes of high-quality therapeu tic relationships include agreement on tasks and common goals; trust, authenticity and positive regard; shared decision-making and responsiveness; and high-quality interpersonal skills (Horton et al., 2021). Tickle-Degnan (2002) identified three pe riods in therapeutic relationships: building rapport, developing working alliances, and maintaining relationships. First, building rapport is an important step in developing professional relation ships. It is defined as “a close and harmonious relationship in which the people or groups concerned understand each other’s feelings or ideas and communicate well” ( Evatt and Scanlan (2022) emphasized the importance of helping clients to feel safe and secure as a founda tion for engagement. As one of their participants stated, “I just don’t think you’re going to get much success in anything else if you don’t have the rapport there in the first place” (pp. 5–6). Rapport can occur naturally when therapists and clients

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