Exam 12: Understanding and Managing Difficult Behavior

Which of the following is not a step in the Intentional Relationship Model (IRM)'s interpersonal reasoning process for managing difficult behaviors?

A phenomenological perspective assumes that whatever the underlying cause of a behavior, the person who is behaving problematically is doing so on the basis of distorted or maladaptive ways of thinking about events.

If a client has difficulty providing the therapist with feedback, has a hard time asserting needs, and does not seem to want to participate in therapeutic decision-making, the collaborating mode is likely to be the most effective choice as a predominant mode for interaction in therapy.

Which of the following challenging interpersonal behaviors encompasses allowing or encouraging the therapist to do things that one is capable of attempting or doing on his or her own or striving to please the therapist and relying on the therapist's approval to determine one's self-worth?

Mr. Bean, an adult client with an intellectual and developmental impairment that affects his speech, is having a stressful day in therapy. You have tried coaxing him into speaking using your favorite football game and by playfully singing his favorite phrase, "Get ready, get set, GO!" Usually this works and he completes the phrase by responding "GO!" but today it is not working. Instead, he says the game is "stupid." What mode is not working and what other mode might be the best one to try next?

Which of the following challenging interpersonal behaviors encompasses a failure to communicate authentically with the therapist and provide feedback about personal experience of therapy?

One explanation for the individual's motive behind manipulative behavior is that the person may hope to have another individual assume responsibility for every decision, behavior, or thought that one might have to free oneself from the burdens of everyday life.

One explanation for the individual's motive behind hostility is that the person utilizes hostility as a means of expressing fear or sadness.

Which of the contemporary approaches explains the mechanisms underlying difficult interpersonal behaviors as a manifestation of a maladaptive dynamic within the larger social system of which the client is a part?

Mrs. Filosoof, an adult client with complications in her shoulder from a stroke, appears disengaged from therapy. She makes a "door-knob comment" that she cannot wait to be discharged from the hospital because she finds the environment rather oppressive. When you ask her more about it, she discloses that she doesn't see the point in doing the exercises that you and her other therapist have been recommending. She reports that she feels particularly irritated when the other therapist asks her if she has been "doing her homework" in-between sessions. What mode is not working and what other mode might be the best one to try next?

Lately, Joanne has been finding herself feeling at odds with one of her clients. Whenever she introduces a more challenging sequence of range of motion exercises, he begins to complain of pain and accuses her of ignoring his limitations. At first, he did this in a joking manner, but now it seems he is serious about it. In addition to downgrading the task itself, from an interpersonal perspective Joanne has tried strategic questioning, problem-solving, reassurance, and becoming stronger and clearer with respect to her instructions and expectations. None of these has worked to stop the complaining. When it comes to use of self with difficult or resistant clients, which aspect of communication does Joanne most need to work on?

According to the Intentional Relationship Model (IRM), what mode is least effective when managing a resistant client?