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2022 Spelbring Endowed Lecturer

Renée R. Taylor, MA, PhD, LP

Overcoming Therapeutic Impasses: The Intentional Relationship Model as an Evidence-based Practice Approach

The objective of this presentation is to reflect upon the historical literature on the therapeutic relationship, identify areas of weakness in knowledge about use of self in occupational therapy, and describe a conceptual practice model that addresses the practical skills necessary for successful therapeutic relationships, even with the most difficult of clients. Two published research studies contributing to model development will be described. Findings from the first study of 568 occupational therapy practitioners suggest that many practitioners are under-educated about issues pertaining to the client-therapist relationship. Irrespective of practitioners’ age, sex, experience level, setting, treatment intensity, and client impairment, those who placed higher value on use of self and had more training related to the therapeutic use of self were more likely to report interpersonal difficulties in clients. They were also more likely to report feelings of positive regard for their clients. Similarly, practitioners placing higher value on the therapeutic relationship and use of self were more likely to report concerns about clients. The second study compared the use of different interpersonal styles (modes) across practitioners and found that the use of empathy was lower than other modes. A battery of empirically validated, brief assessments of mode use and client interpersonal characteristics will be presented for application in didactic and clinical fieldwork education settings. The author will argue that the intentional relationship model provides a theoretical foundation for brief assessment use and practice-based outcomes research in occupational therapy. Additionally, it provides new insight into problem-based and experiential educational approaches in this area. Finally, it may ultimately serve to improve clinical practices by providing new concepts and concrete, usable clinical skills to improve client-therapist relationships in occupational therapy.   

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