UNIT II Aspects of Professional Reasoning


TABLE 11-1 Considerations for Tailoring Interaction to Individuals and Groups ( continued )


Consider: Pitch: A high pitch can be stimulating, a lower pitch has a calming effect. Pace : Fast-paced speech can communicate excitement and encourage ment and be highly stimulating. A slower, steadier rate of speech can be soothing. Pausing and breaking speech into short chunks can em phasize questions or particular points when giving information. Using fewer words or key words can assist clients to process meaning and pay attention to particular concepts. Intonation : Varied intonation maintains the client’s interest and attention. Even intonation is calming but can reduce attentiveness. Volume : High volume, low volume, and variation in volume can all be effective in maintaining the listener’s attention or emphasizing a point. Factors such as clients’ auditory skills, sensory sensitivity, and general personality will determine which is most effective at any point in time. Social chat can help make clients and significant others feel comfortable at the beginning of an interaction or during rest times. Neutral topics such as the weather or how their day has been can establish a pattern of commu nicative exchange before focusing on health-related discussion. Enquiring about the client’s extended family, work, or other activities also conveys interest in them and establishes an informal atmosphere for further inter action.Try to avoid initiating conversation that may undermine your initial connection with the client or significant others, for example, politics or other controversial topics, unless you know the client well. Discovering shared interests can assist in building a connection with the client.This occurs when the therapist takes note of the client’s appearance, actions, or comments and shares stories that illustrate a point of common ality. Ensure that the focus of discussion remains on the client. The level of formality adopted needs to be matched to each client.To determine this, listen to the structure of speech and the language used by the person and reflect this. Use simple terminology and lay explanations, or even colloquial isms. Some clients appreciate in-depth information and more technical expla nations. Seek feedback on whether information giving is clear and useful for clients. Individualizing conversational style needs to remain authentic. Humorous comments and exchanges can serve to lighten the mood of the interaction, provide relief from a tense situation (e.g., the client’s frustration when attempting difficult tasks), and build or strengthen the relationship. The client’s general communication style and response to casual conversa tion should be noted before using humor to ensure that it is not interpreted as flippancy or minimizing the client’s concerns.The style of humor favored by the client is also worth noting, because there are generational and per sonal differences. Appropriate and respectful use of humor can help estab lish a partnership and bond with the client in tackling what lies ahead. Experienced therapists speak of moments during client interaction when a shared understanding is reached or shared joy is experienced.These points are reached through careful attention to all the preceding considerations.

Conversing about other topics

Seeking points of commonality

Mirroring conversational style

Use of humor

Meaningful moments of connection

Sourced from Copley, Nelson,Turpin, Underwood, and Flanigan (2008), Crepeau and Garren (2011), Di Rezze, Law, Eva, Pollock, and Gorter (2014), King et al. (2014), Lawlor (2012), Nelson and Allison (2007). Factors influencing ther apists’ interventions for children with learning difficulties. Canadian Journal of OccupationalTherapy, 75 (2), 105-113. doi:10.1177/000841740807500206; Crepeau, E. B., & Garren, K. R. (2011). I looked to her as a guide: the therapeutic rela tionship in hand therapy. Disability and rehabilitation, 33 (10), 872-881. doi:10.3109/09638288.2010.511419; Di Rezze, B., Law, M., Eva, K., Pollock, N., & Gorter, J. W. (2014).Therapy behaviours in paediatric rehabilitation: essential attributes for intervention with children with physical disabilities. Disability and Rehabilitation, 36 (1), 16-22. doi:10.3109/09638288 .2013.775358; Lawlor, M. C. (2014).The particularities of engagement: Intersubjectivity in occupational therapy practice. OTJR: Occupation, Participation and Health, 32 (4), 151-159. doi:10.3928/15394492-20120302-01

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