How has the therapeutic use of self been used over time throughout Occupational Therapy’s history?
Interventions in occupational therapy use occupation (that is, any activity which is meaningful to an individual person) in order to achieve a particular therapeutic outcome. The same activity could be used by different therapists but in different ways to achieve different therapy goals. The same activity could be carried out by the SAME therapist with different clients in order to achieve different goals! To illustrate this point, consider gardening; an occupation which many people find meaningful.
The activity of planting seeds in a greenhouse. For one therapist, this could be creating repetitive upper limb and grasp movements in the low-tone limb of a stroke patient, to therapeutically restore neural connections for motor movement via neuroplasticity theory. For another therapist this could be teaching a learning disabled patient new skills in communicating with others and managing frustrations appropriately, in order to make successful socialising in the community and gaining employment more likely, via behavioural theory.
The same activity, but carried out with different end goals that the therapist wants the patients to achieve, and therefore different clinical reasoning behind it.
In this sense, it is not what you do, but why you do it.
Interventions can be grouped according to the type of goal they’re achieving:
You may have come across the term before, you may not, but if you’re an OT you’ve probably utilised it without realising already. Therapeutic use of self is a useful technique employed by occupational therapists in order to engage clients and therefore illicit a better outcome during the OT process. Essentially it’s being aware of yourself (your verbal language, body language, which personal information you choose to share…) when you’re interacting with a client, and using your own personality & interpersonal skills in order to build rapport and ultimately make the client feel at ease, motivated, and that they can trust you.
In order to use yourself therapeutically, you must first be aware of your interactions with a client to then be able to adapt them to suit the style of the client. It can be useful to consider some models in order to structure your thoughts, and provide guidance for an occupational therapy student who is just beginning to reflect on their own therapeutic style.
Taylor (2008) has recently proposed the Intentional Relationship model, which categorises the six therapeutic modes -or types of client-therapist interactions- into six categories.
The modes in the Intentional Relationship model (IRM) are: Read more