Reasoning

UNIT II Aspects of Professional Reasoning

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lives, and what they would like to see working better. Copley et al. (2008) found that an expert occupational therapist working with clients with neurologic conditions sought information about clients’ past therapy experiences and their current atti tudes toward and expectations of therapy. The therapist used information about clients’ current resources and social supports to understand whether they could commit to specific interventions. In the case of clients who cannot answer direct questions about what is important to them, occupational therapists must use al ternate ways to discover this such as attending to their nonverbal behavior and talking with other people who are important in their lives. Understanding clients’ lives involves understanding their cultural context. In some areas of practice, for example working with indigenous people, respect for culturally valued ways of knowing and communicating is paramount to progres sion of the therapeutic process (Nelson & Allison, 2007; Restall & Egan, 2022). For example, Hill et al. (2017) found that attention to culturally responsive interaction with children and teachers within an Australian indigenous school was critical for occupational therapy and speech pathology students to successfully provide therapy. Skilled interactive reasoning is critical for gathering comprehensive information that is accurate and representative of the client’s daily life and priorities. Occupa tional therapists are constantly processing responses from clients and significant others, restating their understanding, probing for more detail, checking their inter pretations, and asking related questions. This helps them gradually form a clearer picture of their clients’ situations. For example, Colclough et al. (2015) found that occupational therapists being trained to work with clients with upper limb hyper tonicity learned to interview clients in a responsive manner. They used dynamic, “in the moment” reasoning to inform subsequent questions and information giving. One participant commented, “there was a lot of reflection with the client, a lot of clarification, a lot of to-ing and fro-ing of information. Asking [the client] a question and they might give you some information, you might educate them a little bit.” (p. 1420) The process of gathering information needs to be flexible enough to follow the cli ent’s lead and to move smoothly from one topic area to another. While many or ganizations provide purpose-designed assessment tools to streamline information gathering for occupational therapists in busy work environments with demanding caseloads, these tools can constrain flexibility and responsiveness to the person’s experiences and perspectives. To guide more comprehensive, flexible, and individ ualized information gathering, Copley and Kuipers (2014) proposed a concept map structure, which could be used to develop expertise in this aspect of interactive reasoning. A concept map is a diagram in which ideas and information are placed in boxes or circles and connectors are used to indicate their relationships (see Learning Activity 11-1). Engaging the Client and Significant People Occupational therapists require the active participation of their clients (Taylor, 2019). Clients often need to undertake activities that are difficult for them, and inter actions and relationships can be pivotal to engaging them in these activities. Occu pational therapists need to decide how best to engage specific clients in assessment and intervention, because people have such diverse interests, values, personalities, and circumstances, and their motivations to participate will differ. Occupational

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