Exam 7: Uncomplicating the Complicated: the Interpersonal Reasoning Process

You are working in an inpatient rehabilitation hospital. You have just received a referral for a 19-year-old male client who suffered a severe spinal cord injury from a skiing accident. You have overheard the nurses describing the client as angry, aggressive, and reluctant to begin therapy. As you review his chart and plan for treatment, you anticipate that he will be resistant in therapy. When you approach his bedside, the client begins to yell, "Leave me alone, I'm not doing anything today!" At this point you begin to take a deep breath and remind yourself that this is a typical response in newly disabled clients. You are currently using what interpersonal reasoning step?

Which of the following is not a step in interpersonal reasoning?

Mr. Pesty, who experienced a brain injury when hit by a steel pole at work, is being seen on an inpatient neurology unit. You arrive on the unit to hear that, today, he has been refusing to take medications. You also learn that, today, the speech and physical therapists describe him as difficult to work with. You have been ordered by the referring neurologist to assess Mr. Pesty's functional independence. Before you enter this client's room, what aspects of the Intentional Relationship Model (IRM) would be important to keep in mind?

According to the Intentional Relationship Model (IRM), it is permissible and sometimes desirable for a therapist to shift his or her interpersonal mode entirely in response to an interpersonal event that occurs during the course of a session.

Tom was working with a client, Bill, who had recently injured his hand in a work accident. The therapist has become frustrated with Bill because he often complains that the activities are too hard and too painful. After a long day of clients, Tom responded to Bill's comments by saying, "Come on, it's not that hard!" Which potentially nontherapeutic response did Tom use?

According to the Intentional Relationship Model (IRM), which of the following is not included in the interpersonal reasoning process?

Although interpersonal reasoning is important for establishing a therapeutic relationship, clinical reasoning takes priority in facilitating occupational engagement.

What potential risk does the response in question 1 have on the client?