Deck 7: Uncomplicating the Complicated: the Interpersonal Reasoning Process

Question 1

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?

A) Parental response
B) Defensive response
C) Minimizing response
D) Confused response

Answer 1

Minimizing response

Question 2

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

A) The client may feel confused by the therapist.
B) The client may experience it as invalidating or judgmental.
C) The response may cause the client to become overreliant.
D) The client may perceive it as the therapist not listening to his concerns.

Answer 2

The client may perceive it as the therapist not listening to his concerns.

Question 3

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

A) Drawing upon relevant interpersonal skills
B) Determining if a mode shift is required
C) Gathering feedback
D) Doing what is most comfortable or habitual

Answer 3

Doing what is most comfortable or habitual

Question 4

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

A) Anticipate
B) Identify and cope
C) Determine if a different conceptual practice model should be applied
D) Determine if a mode shift is required

Question 5

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?

A) It is possible that the other therapists lacked an understanding of brain science and so it would be important to characterize Mr. Pesty's behavior in terms of which areas of his brain were affected by the injury to better refine your biomechanical treatment goals.
B) It would be important to adhere strictly to what the physician ordered, and to begin the session with a brief assessment of Mr. Pesty's functional independence.
C) When introducing yourself, it would be important to anticipate that an interpersonal event might occur, to make mental note of some of Mr. Pesty's client characteristics, and to show Mr. Pesty that you are willing to try different modes of communicating and responding.
D) All of the above

Question 6

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?

A) Anticipate
B) Identify and cope
C) Determine if a mode shift is required
D) Gather feedback

Question 7

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

Question 8

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.