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Sign-in, grab a handout, and write down 3 good things :)!

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Step 2:

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Applying the Intentional Relationship Model to Everyday Interactions

Evguenia S. Popova, PhD, OTR/L (she/her)

Name Pronunciation Resource

Assistant Professor

Rush University, Department of Occupational Therapy

Rush University

1. Evaluate personal strengths, opportunities, aspirations, and results (SOAR) based on the Intentional Relationship Model (IRM)
2. Develop a personal professional action plan based on the IRM
3. Apply the IRM Interpersonal Reasoning Process to case examples

Objectives

1. SOAR
2. Review
3. Interpersonal Reasoning Process
4. Reflections
5. Q&A

Agenda

Everything you need for our workshop can be found here: https://sites.google.com/view/intentional-relationship-model/

Course Overview

Tips

• “Dare to be dull.”
• “Just make a choice.”
• “Make it about the present.”
• “Be more brave than impressive.”
• “Make a connection with the other person.”
• “Just listen and react to what was actually said.”
• “You have to understand why you’re in that role play.”

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For more tips, check out this blog.

Communication Lessons from Improv

Life Lessons from Improv (Chris Gethard)

• Say yes to each other
• Be present in the moment
• Remember that “slow is fast”
• Ask yourself:
• Why these people?
• Why here?
• Why now?

Communication Improv Game:

"Word at a time"

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Let’s review what we know about the intentional Relationship Model (IRM) while practicing improv:

• One person in the group starts a story with one word, and each person chimes in, adding one additional word.
• Listen and be present in the moment to help keep your thoughts free from directing the story.
• If you are stuck, you can “tap out” and Zhenya will tap in to help you out.
• Kick Off Statement:
• I may have dreamt it; however, I remember that the Intentional Relationship Model is about…

Strengths, Opportunities, Aspirations, and Results (SOAR)

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Strengths, Opportunities, Aspirations, and Results (SOAR)

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Thinking about what you learned about IRM, identify:

• 3 interpersonal strengths
• 3 interpersonal opportunities
• 1 aspiration toward developing a stronger therapeutic use of self
• 1 goal that you can track over the next month to measure your progress
• 1 question you hope to have an answer to today

THINK

(1 min)

PAIR

(3 min)

SHARE

(5 min)

Our Strengths

Our Opportunities

Our Strategies

Review:

Intentional Relationship Model

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Inevitable Interpersonal Events

Client’s Interpersonal Characteristics

Therapist’s Interpersonal Skills

Client’s Engagement

Six Therapeutic Communication Modes

Advocating

Collaborating

Encouraging

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Empathizing

Instructing

Problem-solving

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Advocating Mode

Definition:

Working with the client on overcoming physical, social, and environmental barriers that they may encounter, supporting the client’s access to resources and services, normalizing the client’s experience.

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Examples:

• Providing information about about an accessible playground in the community.
• Providing information about local peer support and advocacy groups.
• Providing information about legal rights of children, parents, and families with disabilities.

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Collaborating Mode

Definition:

Letting go of control and supporting the client’s autonomy and independence in the decision-making process, ensuring that the client has an active role throughout the treatment process.

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Examples:

• Facilitating opportunities for the person to select an activity of their choice.
• Facilitating opportunities for the person to select their own rehabilitation goals.
• Following the person’s lead during an activity or a situation.

Empathizing Mode

Definition:

Understanding and validating the client’s physical, psychological, and emotional experience, use of summary statements, active listening.

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Examples:

• Actively listening to the person’s concerns and challenges.
• Validating the person’s experience using summary statements.
• Validating the person’s experience by mirroring the client's emotional tone and feelings and non-verbal communication.

Encouraging Mode

Definition:

Fostering hope, use of positive reinforcement and encouragement, rewarding the client.

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Examples:

• Praising the person for successful completing a challenging or novel task.
• Rewarding positive behavior through tangible reinforcement or social praise.
• Instilling hope by reminding the person of their accomplishments.

Instructing Mode

Definition:

Taking on a role of an expert guide or a teacher, providing structure and feedback, providing clear feedback on the client’s performance.

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Examples:

• Teaching the strategies and techniques (e.g., self-management or self-regulation strategies)
• Demonstrating, physically cuing, or providing physical assistance
• Explaining the order of activities or the steps required to complete a task

Problem-Solving Mode

Definition:

Utilizing logic, facilitating problem-solving and analytical reasoning, use of strategic questioning, outlining the options available the their client as well as any potential outcomes.

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Examples:

• Supporting the person’s ability to think critically and problem-solve through a challenging task.
• Supporting the person’s ability to break down the steps of a new task.
• Outlining the pros and cons of a new task and potential safety concerns that might arise.

• When someone is helping you, which mode do you prefer for them to use the most? What about the least?

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• When you are helping someone, what mode do you prefer to use the most? What about the least?

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• What mode do you wish to get stronger at? Why?

Advocating

Problem-solving

Collaborating

Empathizing

Encouraging

Instructing

Discussion

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Example

Interpersonal Characteristics

Can be situational or enduring, include:

• Communication style
• Tone of voice
• Body language
• Facial expression
• Response to change or challenge
• Level of trust
• Need for control

• Approach to asserting needs
• Predisposition to giving feedback
• Response to feedback
• Response to human diversity
• Orientation toward relating
• Preference for touch
• Interpersonal reciprocity

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Example

Naturally occurring events that happen as part of a normal course of therapy, including:

Inevitable Interpersonal Events

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• Expression of strong emotion
• Intimate self-disclosures
• Power dilemmas
• Nonverbal cues
• Verbal innuendos
• Crisis points
• Resistance and reluctance

• Boundary testing
• Empathic breaks
• Emotionally charged therapy tasks and situations
• Limitations of therapy
• Contextual Inconsistencies

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Example

• Delivered through verbal or non-verbal means
• A therapist that is able to effectively use a variety of modes is considered as having a multimodal interpersonal style
• Emotional congruence = consistency between verbal and nonverbal communication
• Mode Matching = ability to anticipate and adapt which interpersonal mode best fits with the client’s needs
• Mode Versatility = applying modes flexibly using mode shifts

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Therapeutic Communication

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Barriers to Therapeutic Communication

Raising Our Awareness of Therapeutic and Non-therapeutic Communication

WHO: Teams of 3

• Client: Share a problem or a question that you want help with today (e.g., “What should I have for dinner?”)
• Therapist: Roll the mode dice and try to communicate in that mode as long as possible; re-roll whenever you want!
• Observer: Provide feedback and assistance (as needed)

WHAT: 3 minutes in each role; 12 minutes total

• Try and practice as many modes as possible
• Aim for congruence, mode matching, and versatility
• Watch for incongruence, mixed modes, and mismatch

HOW: Dice or Wheel of Names

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1. What were your biggest takeaways from this activity?

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• Were some modes easier or harder than others?

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• What was it like to switch roles between therapist, client, and observer?

THINK

(1 min)

PAIR

(3 min)

SHARE

(5 min)

Interpersonal Reasoning Process

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Interpersonal Reasoning Process

Moment of Reflection

Imagine the last difficult interaction you had with another person.

Interpersonal Reasoning Process

• Step 1: Anticipate, knowing that difficult behaviors are natural and common aspect of the therapeutic process:
• What are the client’s interpersonal characteristics?
• What interpersonal events happened in the past?
• What interpersonal events might happen in the future?

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Interpersonal Reasoning Process

• Step 2: Identify, cope and strive for understanding, a process of inquiry and reflection which supports objectivity and responding in an intentional/controlled manner:
• Remain mindful → Pause and identify what is happening
• Respond with self-compassion → Take a moment to empathize with yourself
• Respond with empathy → Take a moment to empathize with your client

Interpersonal Reasoning Process

• Step 3: Determine if mode shift is required, is it the mode you chose to use or your use of that mode?

Interpersonal Reasoning Process

• Step 4: Choose a response mode

Setting an Emotional Climate

Interpersonal Reasoning Process

• Step 5: Draw on any relevant interpersonal skills associated with that mode
• Step 6: Gather feedback
• Repeat!

• Your client defines the successful relationship
• There is a difference between interpersonal and therapeutic goals
• It is important to maintain a balance between activity focus and interpersonal focus while working with others

Rush University | 3/17/22

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Let’s Practice!

Watch the dinner scene video from Inside Out film:

https://www.pixar.com/feature-films/inside-out

Step 1:

Step 2:

Apply the Intentional Relationship Model:

• Identify the interpersonal characteristics. Is there a match or a mismatch? How can you tell?
• Identify the interpersonal events.
• Identify the modes used by the child’s parents. Is there a match or a mismatch? Do you notice any mode incongruence or mixed mode use?

Based on your analysis of this situation:

• Develop a set of IRM-based recommendations for the little girl’s parents.
• Identify how your recommendations would defer for the girl’s mom vs. dad.
• Identify how you could use coaching to facilitate a more therapeutic approach to resolving this conflict.

Step 3:

Reflections

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Therapeutic Communication Research

(Popova et al., 2022)

CAM & CASI-SF Interpretation:

0 - Never

1 - Rarely

2 - Sometimes

3 - Frequently

Therapeutic Communication Research

(Popova et al., 2022)

Let’s Develop and Action Plan

THINK

(2 min)

PAIR

(4 min)

SHARE

(5 min)

Thoughts-Questions-Epiphanies

Share your thoughts, questions, and epiphanies!

Google Form Link: https://forms.gle/hTYEt7sE8NrECuCD8

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Preparing for October

• Review Session 3 and Session 4 resources posted in Google Sites
• Submit Session 4 reflection via REDCap
• Email with any questions!

Email me!

Evguenia S. Popova, MS, PhD, OTR/L

Evguenia_S_Popova@rush.edu

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Intentional Relationship Model Clearinghouse: https://moho-irm.uic.edu/

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References

Taylor, R. R. (2020). The intentional relationship: Occupational therapy and use of self (2nd ed.). Philadelphia: F.A. Davis Co.

Popova, E. S., O’Brien, J. C., & Taylor, R. R. (2022). Communicating with intention: Therapist and parent perspectives on family-centered care in early intervention. American Journal of Occupational Therapy, 76, 7605205130. https://doi.org/10.5014/ajot.2022.049131