Ch05

Chapter 5
Being Client-Centered: Understanding

Interpersonal Characteristics and Mode
Preferences
Copyright ©2020 F.A. Davis Company

Learning Outcomes
 Differentiate the meaning of client-centered

practice according to the Intentional
Relationship Model (IRM).
 Associate knowledge of the client’s
interpersonal characteristics with the notion of
client-centered practice.
 Describe the relevance of the 14 categories of
client interpersonal characteristics to clinical
practice and mode use.

Learning Outcomes (continued_1)
 Recognize the strengths and complexities of

client interpersonal characteristics within each
of the 14 major categories.
 Define client interpersonal characteristics as
either situational or enduring.
 Understand the clinical importance of
differentiating situational characteristics from
enduring characteristics.

Learning Outcomes (continued_2)
 Assess client mode preferences as a means of

understanding how to enrich the understanding
of a client’s interpersonal needs.

Client-Centered Practice: What It Meant
Before the IRM
 Until recently, client-centered practice referred
mainly to the importance of collaboration,
autonomy, and choice.
 Until recently, client-centered practice focused
on emphasizing the client’s strengths and the
knowledge and capacities he or she brings to
the therapy process.
 Client empowerment and independence will
lead to greater participation, which is upheld as
the ultimate goal in OT practice.
Client-Centered Practice: What It Means
According to the IRM
 One cannot argue that participation represents
a cornerstone of our field and is important for
quality of life and overall health.
 At the same time, not all of our clients may
participate in therapy at a level that we would
expect or hope for on their behalf.
 It may be difficult for us to acknowledge that
many of the reasons for a client’s suboptimal
participation are beyond our control as
therapists.
According to the IRM (continued_1)
 IRM acknowledges that clients’ abilities to
participate will vary according to
• Clients’ views of the world
• What matters most to them
• What they enjoy
• How they feel about their abilities
• Availability of resources and opportunities in their
settings
• Cultural contexts

• Skills they possess or do not possess at a given
moment
• Specific nature of their impairments

 Kielhofner (2009) first broadened the term
client-centered in occupational therapy.
 To Kielhofner, above all, being client-centered
means taking the time to appreciate and
respect how the client is experiencing the
therapy process.
 For some clients, being client-centered may
very well involve collaboration and
empowerment.

 But for others, being client-centered may
involve advocating for the client.
 And for others, being client-centered may
involve striving to understand the client’s
experiences and desires.

 Many aspects of the IRM are consistent with
this more variegated understanding of client-
centered practice.
 In IRM, being client-centered involves
actively and reflectively seeking to know and
understand each client’s unique
interpersonal characteristics and
communication (mode) preferences.

Client Interpersonal Characteristics
 These include a client’s emotions, behaviors,

and reactions that occur during interactions
with the therapist.
 These interpersonal communications and
behaviors may vary in frequency or intensity
depending on the client’s circumstances.

Situational Versus Enduring
 Situational interpersonal characteristics:

• When clients’ interpersonal behaviors are largely
linked to the experience of their impairments or
some other external stressful circumstance, they
are referred to as situational.
‒ (e.g., an otherwise polite and easygoing client sounds
irritable and raises her voice slightly at the
occupational therapist because the nurse is an hour
late with her pain medications)

Situational Versus Enduring (continued)
 Situational interpersonal reactions are likely to

be witnessed when therapists encounter clients
with a . . .
• New impairment or illness situation
• Exacerbated impairment or illness situation
• Fatigue, sleep deprivation, or other symptom flare-up
• Other medically related crisis point
‒ Clients are more vulnerable to experience loss or stress
related to the effects of the impairment on occupational
functioning.

Situational Characteristics
 Are the result of interruptions in . . .

• Daily life routines
• Established roles
• Level of independence in physical and cognitive
functioning
• Employment or economic situations
• Friendships
• Intimate relationships
• Parenting
• Emotional well-being
Situational Characteristics (continued_1)
 The impairment experience may involve:

• Social stigma
• Fatigue
• Pain
• Discomfort
• Anxiety
• Comparative feelings of insecurity or low self-worth
• Uncertainty about the future
• Stressful interactions with health-care system

These experiences and consequences may

predispose clients to:
• Feel overwhelmed or shocked
• Feel isolated or misunderstood
• Feel sadness, grief, or acute awareness of loss
• Feel helpless, subjugated, or powerless
• Feel irritable or angry
• Have a heightened sensitivity to negativity
• Feel nervous, preoccupied, or tense

• Contemplate mortality and meaning
• Be withdrawn or highly emotional
• Feel insecure and need increased support
• Seek information or feel confused about
treatment

 These are normative and common reactions

to the situation of health care.
 The same skills, modes, and reasoning
processes of IRM may be applied, but they
may vary in terms of emphasis, duration,
and intensity.

Enduring Interpersonal Characteristics
• Emotions, behaviors, and reactions that mostly
emanate from underlying traits of the client are
referred to as enduring interpersonal
characteristics.
• They reflect the client’s baseline interpersonal
style that is relatively constant across time,
people, and contexts.

14 Client Interpersonal Characteristics
 Communication style
 Tone of voice
 Body language
 Facial/Postural expression (affect)
 Response to change and challenge
 Level of trust
 Need for control
 Approach to asserting needs

14 Client Interpersonal Characteristics
(continued)
 Predisposition to giving feedback
 Response to feedback
 Response to human diversity
 Orientation toward relating
 Preference for touch
 Interpersonal reciprocity

Communication Style Is a Function of . . .
 The client’s natural predisposition toward

communicating with others
 How a client might be thinking or feeling
toward the therapist
 The client’s social and cultural background
 Developmental disorders
 Neurological or neuromuscular impairments
or diseases
 Symptoms of a psychiatric disorder
Communication Style Is a Function of . . .
(continued)
 Effects of intoxication with a substance
 Transient feelings about the situation
 Comfort level and confidence with respect to
the language being used during the
interaction (if it is not the client’s first
language)

Communication Style
 If a client’s communication style is

idiosyncratic or cumbersome, it may require
the therapist to
• Strain to understand what the client is saying
• Adapt his or her own communication style to
better match the client’s
• Work harder to make the client feel more
comfortable communicating with the therapist
• Work harder to help the client contain his or her
communication

Communication Style: Diverse Examples
 Strength – The client’s communication is

unremarkable in pace, quality, and quantity.
 The client does not communicate with formal
sign language or spoken language.
 The client is capable of language but refuses to
communicate.
 The client is reluctant (will talk/sign if questioned
or encouraged) but provides limited answers and
volunteers little, spontaneous speech.

Communication Style: Diverse Examples
(continued)
 The client’s articulation or accent is unfamiliar
to the therapist or difficult to understand.
 The client uses idiosyncratic vocalizations or
gestures.
 The client speaks slowly.
 The client speaks rapidly.
 The client is hyperverbal–speech/sign is
excessive or rambling.

Work in Small Groups
 Place yourself in the role of a client. Reflect

upon how an occupational therapist might
perceive your communication style as an
enduring interpersonal characteristic.
 Share your self-reflection with your peers, if
you are comfortable doing so.
 Ask your peers if they perceive your
communication style as you have described it.

Tone of Voice
 May provide a window into one’s emotional

state and reactions during an interaction.
 Unusually loud, soft, or shrill tones may reveal
an emotional state or may result from a
physical, neurological, or sensory issue.

Tone of Voice (continued)
 Speaking slightly but noticeably louder or softer

than others could also accompany certain other
interpersonal characteristics and styles,
revealing a more dominant style or a lack of
confidence, for example.
 A low tone of voice as a situational
characteristic may reveal underlying anger.

Tone of Voice: Diverse Examples
 Strength – The client exhibits an average or

unremarkable tone of voice.
 The client speaks softly or mumbles.
 The client speaks with a low, sad, or
demoralized tone.
 The client speaks with a monotonic tone
(without variation in emphasis or pitch).
 The client speaks with a tense or stressed
tone.

Tone of Voice: Diverse Examples
(continued)
 The client speaks softly or mumbles.
 The client speaks with a low, sad, or
demoralized tone.
 The client speaks with a monotonic tone
(without variation in emphasis or pitch).
 The client speaks with a tense or stressed tone.

Work in Small Groups (continued_2)

perceive your tone of voice as an enduring
interpersonal characteristic.
 Ask your peers if they perceive your tone of
voice as you have described it.

Body Language
 In an open, relaxed, or neutral posture, the

client’s eyes, head, and body will be fluid and
oriented toward the therapist.
 A closed body posture may reveal a reluctance
to interact or it may reveal that a client is
feeling demoralized, or angry. If the head is
down, the shoulders are slouched, and the
eyes are cast downward, it may reveal that the
client is feeling insecure, or submissive.

Body Language (continued)
 Anxiety may be reflected by stiffness, quick

movements, or fidgeting.

Body Language: Diverse Examples
 Strength – The client exhibits an open, relaxed,

or neutral/unremarkable posture (eyes, head,
and/or body are oriented appropriately toward
the therapist or other person; no crossing of
arms or legs).
 The client exhibits a submissive or demoralized
body position or gestures (torso slouches or
crouches down, head is down despite eye
contact).

(continued_1)
 The client exhibits a closed body position
(arms and/or legs are crossed, body may be
slightly-to-completely turned away).
 The client exhibits watchful or hypervigilant
body language (checks doors or locks,
responds to movements across the room or
out the window, looks around a lot, facial or
body muscles tense).

(continued_2)
 The client exhibits anxious or impatient body
position or gestures (rapid body movements;
rapid eye movements; fidgets with objects or
body parts; rocks body; swings, shakes, or
wiggles legs; twitches; paces).
 The client exhibits an affiliative or
affectionate posture or gestures (may lean
inward, sit or stand closely, make prolonged
eye contact, or reach out to touch).

(continued_3)
 The client exhibits a dominant or aggressive
body position or proxemics (hands on hips or
folded in judgment, leaning in toward the
therapist or other person in a manner that
causes discomfort, standing over or standing
too close to the therapist or other person,
sitting too close, fists may be clenched).


perceive your body language as an enduring
interpersonal characteristic.
 Ask your peers if they perceive your body
language as you have described it.

Facial/Postural Expression (Affect)
 Affect reveals one’s outward expression of

internal feelings.
 Emotion regulation difficulties may manifest
as follows:
• Exhibiting a range of intense emotions within a
short period of time.
• Exhibiting behavioral impulsivity or poor
judgment.
• Having difficulty controlling emotional reactions.

Facial/Postural Expression (Affect)
(continued)
 An absence of expression, stoicism, or a flat or
blunted affect occurs when a client does not
react to situations that would otherwise
prompt an emotional reaction.
 A client demonstrating an inappropriate
emotional response laughs in a situation that
would be associated with loss, pain, or sadness.
 Alternatively, a client may become sad, angry,
or agitated in a situation where the trigger is
difficult or impossible to identify.
Facial/Postural Expression (Affect): Diverse
Examples
 Strength – There is nothing remarkable
about the client’s facial expression and
emotional reactions during therapy.
 The client’s expression is blank or the client
does not demonstrate facial expression or
emotion.
 The client exhibits a guarded or distanced
facial expression (eyes and/or head may be
cast downward or fixed on a faraway object).

Examples (continued_1)
 The client exhibits a sad or pessimistic
expression (eyes cast downward, may have a
furrowed brow).
 The client exhibits an elated or joyful
expression (smiling or laughing).
 The client exhibits a concerned or anxious
expression (eyes wide open or raised
eyebrows).

 The client exhibits a restless or agitated
expression (facial muscles tense, eyes may be
shifting, facial tics).
 The client exhibits an irritable or frustrated
expression (eye contact may be direct and
intense, may have a furrowed brow or clenched
jaw).
 The client exhibits an angry or hostile expression
(eye contact may be direct and intense, may have
a furrowed brow or clenched jaw).
 The client’s emotions are high/florid and
vacillate between elation, sadness, and/or
irritability within a single meeting.
 The client demonstrates inappropriate
emotion–inconsistent with the circumstance.

Response to Change and Challenge
 Some clients do not allow change or

challenge to interrupt their persistence.
 Other clients may experience difficulty with
small or large changes or challenges.
 For example, a client with dementia or
psychosis may become agitated by noises or
images on a television, construction noise,
the presence of a new person or people, or
changes in lighting.

Response to Change and Challenge
(continued)
 A client with autism may have similar
difficulties with loud noise, bright lights, or
other sensory stimuli.

Response to Change and Challenge:
Diverse Examples
 Strength – The client accepts change and/or
persists in the face of change or challenge.
 The client doubts himself or herself or his or
her capacity to face the change or challenge.
 The client becomes nervous or anxious.
 The client avoids change or challenge by
attempting to engage in a more familiar or
desirable activity.

Response to Change and Challenge:
Diverse Examples (continued)
 The client shuts down, becomes demoralized,
or gives up.
 The client shows anger or frustration.
 The client openly refuses to try or persist with
the new situation.

Think-Mingle-Share
 Think of a time when you faced significant

change or challenge. How did you respond?

Level of Trust
 Clients without difficulty trusting the therapist

will engage in even the most private of
therapeutic activities or conversations with a
willing and unquestioning approach.
 Conversely, difficulties with trust may reveal
themselves in a client’s questions, choice to
withhold information, or reluctance to engage
in a task or activity.

Level of Trust: Diverse Examples
 Strength – The client is able to develop an

appropriate level of trust within the
therapeutic context.
 The client is extremely cautious or
apprehensive about the therapy process.
 The client withholds information or attempts to
hide things from the therapist.
 The client double checks the therapist’s actions
or recommendations with another source.

Level of Trust: Diverse Examples
(continued)
 The client reports a mistake or injustice that he
or she experienced with a different provider or
in another health-care context.
 The client questions the therapist with
doubting language and/or tone of voice.
 The client expresses open disagreement with
the therapist’s approach or recommendations
in a manner that seems excessive.
 The client engages in behaviors that test the
therapist’s level of commitment.
Need for Control
 A client’s need for control will vary based upon

both the client’s and the therapist’s
expectations for the degree to which the client
will direct the events and goals of therapy.
 People’s need for control will also vary based
upon their own cultural expectations,
particularly as they may play out in traditional
“patient” and “provider” roles.

Need for Control (continued)
 A client who attempts to exert excessive

control over the therapy process may impede
the therapist’s ability to provide the client
with important opportunities, resources,
supports, or knowledge during therapy.
 A client that passively relinquishes control will
miss out in similar ways as the passivity
corresponds to a lack of genuine engagement.

Need for Control: Diverse Examples
 Strength – The client shares control or takes

control of therapy in a way that is productive.
 The client is indifferent, passive, or
relinquishes control of therapy.
 The client requests that the therapist change
his or her approach or recommendations.
 The client ignores the therapist’s attempts at
engagement or direction, or, instead, does
what he or she wants to do.

Need for Control: Diverse Examples
(continued)
 The client engages in actions or activities that
the therapist does not support or
recommend.
 The client introduces an independent agenda
for therapy that runs counter to the
therapist’s agenda.
 The client openly refuses the therapist’s
attempts at engagement or direction.

Approach to Asserting Needs
 Clients vary in terms of their ability to tell us

what they need during therapy, from the
most banal things such as needing a drink of
water, to something more significant, such
as needing to abandon a treatment goal.
 Clients that over-assert their needs run the
risk of coming across as demanding or
abusive, and this can affect the therapist’s
ability to remain centered and objective.

Approach to Asserting Needs (continued)
 Clients that under-assert their needs can

unwittingly cause a self-defeating chain
reaction, in which they continue to place their
own needs aside as they continue to be
increasingly uncomfortable during the therapy
process, in the absence of the therapist’s
knowledge or ability to do anything to help
them feel more comfortable.

Approach to Asserting Needs: Diverse
Examples
 Strength – There is nothing remarkable about
the way the client discloses needs or recruits
assistance–the client asks for help when it is
clear that help is needed.
 The client avoids recruiting assistance, making
a request, or asking for support when
something is needed.
 The client drops hints or makes insinuations
about what is needed or desired in a way that
is ambiguous or confusing to the therapist.
Approach to Asserting Needs: Diverse
Examples (continued)
 The client apologizes or contradicts himself or
herself when making a request.
 The client stages, dramatizes, or manipulates
the situation when help is not clearly needed,
making it difficult for the therapist to deny his
or her needs.
 The client asserts needs in an excessive or
demanding manner that is not appropriate for
the level of help that is needed.

Assertiveness
 How would you rate yourself in terms of

your ability to assert your needs with
others?
 Complete the Assertiveness Inventory in
Chapter 8, p. 132 of the Davis book.
 We will discuss further with guest speaker
Week 6

Predisposition for Giving Feedback
 Similar to asserting needs, clients differ in

terms of their abilities or willingness to
provide the therapist with constructive
feedback.
 Though clients may generally be more
comfortable providing their therapists with
positive feedback, they may be less
comfortable sharing with their therapists
what they would prefer them to do
differently.
Predisposition for Giving Feedback: Diverse
Examples
the way the client provides feedback about
therapy or the therapist.
 The client does not provide any type of
feedback (positive or constructive) about
therapy or the therapist, even when it is
solicited.
 The client provides only positive feedback
when there is reason to provide both positive
and constructive (or critical) feedback.
Predisposition for Giving Feedback: Diverse
Examples (continued)
 The client provides constructive (or critical)
feedback in a reluctant or veiled manner
(e.g., by talking about a related person or
circumstance).
feedback in a self-contradictory, ambivalent,
or apologetic way.
feedback excessively.

Think-Pair-Share
 What variables might contribute to a client’s

discomfort with providing negative feedback
to his or her therapist?
 What can a therapist do to increase a client’s
willingness to provide a therapist with
necessary feedback about the therapy
process, even if it is negative or critical?

Response to Feedback
 Corrective feedback during or after

performing an activity can be difficult for any
client to hear.
 Some clients are also uncomfortable
receiving positive feedback about their
performance.

Response to Feedback: Diverse Examples
 Strength – The client responds to both positive

and constructive (or critical) feedback
appropriately.
 The client becomes self-critical or deflated
following constructive (or critical) feedback.
 The client minimizes the importance of the
therapist’s positive feedback.
 The client minimizes the importance of the
therapist’s constructive (or critical) feedback.

(continued_1)
 The client dismisses or ignores the therapist’s
positive feedback.
 The client dismisses or ignores the therapist’s
constructive (or critical) feedback.
 The client accepts positive feedback from the
therapist but dismisses, ignores, or challenges
 The client becomes defensive following

(continued_2)
 The client becomes angry following

Think-Mingle-Share (continued_2)
 Attending occupational therapy school

involves receiving feedback on a regular basis.
 What type of feedback are you comfortable
receiving?
 Is there any type of feedback that you are not
comfortable receiving?

Response to Human Diversity
 Several differences may • Religious orientation
be relevant to the client- • Political orientation
therapist relationship, • Cultural views and belief
including differences in systems
• Sex • National origin
• Gender identification • Disability status
• Race • Educational status
• Ethnicity • Economic status
• Age • Marital status
• Life situation • Parental status
• Developmental level • Sexual orientation
• Intellectual ability
(continued_1)
 According to the IRM, occupational
therapists are professionally and personally
obligated to continually work to improve
their ability to self-reflect upon their own
biases toward others as well as to increase
their knowledge and empathy toward
others, particularly those who are
underrepresented and oppressed.

(continued_2)
 Though the AOTA Code of Ethics requires
therapists to identify themselves and ask for
an exemption when personal, cultural, or
religious values preclude, or are anticipated
to negatively affect, the professional
relationship or provision of services, our
clients are not in a similarly privileged
position.

(continued_3)
 Clients may manifest their difficulties
accepting a therapist’s differences in a range
of ways, including by . . .
• Questioning the therapist directly about their
appearance or personal characteristics
• Making statements about their unwillingness or
inability to work with therapists of a certain
identity
• Making indirect statements indicating discomfort
with working with therapists of a certain identity

(continued_4)
• Making direct statements about a therapist’s
physical appearance
• Making racist, biased, or other offensive
statements

Response to Human Diversity: Diverse
Examples
 Strength – The client’s response to the
therapist’s personal-demographic
characteristics is neutral or there was no
apparent response.
 Strength – The client comments positively or
claims solidarity with the therapist based on
one or more personal-demographic
characteristics.

 The client makes general statements about the
characteristics but does not directly ask or
confront the therapist.
 The client makes a comment about how he or
she differs from the therapist on one or more
personal-demographic characteristics.
 The client asks the therapist questions about
his or her personal-demographic characteristics
in an ambivalent or doubtful manner.
 The client refuses to work with the therapist or
requests a different therapist because of the
characteristics.

Think-Pair-Share (continued)
 Think of a time when someone you were

serving or trying to help made an offensive
statement about one of your personal
characteristics or identities.
 What did you say or do when this individual
offended you?

Orientation Toward Relating
 Clients will differ in terms of the degree of

information they choose to disclose about their
experiences and personal lives, inside and
outside of therapy.
 They will also differ in the degree of emotion
that they are willing to show during therapy or
when describing their experiences outside of
therapy.

Orientation Toward Relating (continued)
 It is important for therapists to read and match

(if appropriate) their clients’ preferences in
terms of the type of relationship they are
seeking to have during therapy.

Orientation Toward Relating: Diverse
Examples
the client’s general approach to the therapeutic
relationship.
 Strength – The client openly discloses
information and appears to take comfort in the
therapist’s attempts to respond on a personal
level.

 Strength – The client prefers a highly
structured, formal, business-like relationship.
He or she does not disclose personal
information and appears comfortable with not
doing so.
 The client appears unattached or openly
dislikes relating to the therapist.
 The client relates with the therapist in an
ambivalent or uncomfortable way.

 The client appears overly attached or overly
consenting/accepting/idealizing of the
therapist.
 The client is anxiously attached–showing a high
need for reassurance or positive regard from
the therapist.

Preference for Touch
 A client’s preference for touch may emanate

from a healthy desire for a more personal
connection with the therapist.
 A client’s negative reaction to touch may be a
symptom for which therapy is being sought, or
a product of his or her interpersonal norms,
cultural beliefs, or past history of trauma.
 A client who reaches out to touch the
therapist may wish to punctuate with emotion
something that is being communicated.
Preference for Touch (continued)
 In some cases, a client may use touch to assert

power within the relationship.
 Some clients may also attempt to use touch
inappropriately because of sexual and/or
dominating impulses.

Preference for Touch: Diverse Examples
 Strength – The client’s preference for touch is

unremarkable or the client appears to respond
positively to any form of touch (caring or
technical).
 The client has clearly articulated an aversion
to touch.
 The client physically shrinks away from or
shows facial signs of discomfort with any form
of touch.

Preference for Touch: Diverse Examples
(continued)
 The client’s difficulty with touch is a sensory
symptom that the client does not want to be
addressed in therapy.
 The client’s difficulty with touch is a sensory
symptom that the client wants to be addressed
in therapy.
 The client initiates touch or seeks out touch
from the therapist such that the therapist feels
the need to set a boundary and/or it makes the
therapist uncomfortable.
 Place yourself in the role of a client and

describe your personal preference for touch
during therapy.
 What is your best advice to other therapists
in terms of responding to your preferences?

Interpersonal Reciprocity
 Clients may vary in their capacity to act

reciprocally toward their therapists
depending upon their physical, cognitive,
and psychological states.

A Client’s Capacity for Reciprocity May Be
Reflected in a Range of Behaviors
 Capable of  Ability to show
understanding the tolerance or patience if
therapist’s point of view a therapist is particularly
when a disagreement preoccupied or
occurs overwhelmed on a given
 Express gratitude to the day
therapist when  Ability to forgive the
appropriate and in a therapist for a minor
way that feels oversight or mistake
comfortable to the
therapist

A Client’s Capacity for Reciprocity May Be
Reflected in a Range of Behaviors (continued)
 Ability to show empathy  Occasionally show
toward the therapist interest in the therapist
(e.g., to sense that the as a human being by
therapist may be having asking questions the
a difficult day and to ask therapist is comfortable
about it or show answering
concern rather than take
it personally)

Interpersonal Reciprocity: Is It Present?
 Strength – The client shows some level of

interest in the therapist as a person. For
example, the client may thank the therapist
for his or her efforts, wish the therapist well,
or notice the therapist’s personal
characteristics or changes in the therapist’s
mood or behavior.

Interpersonal Reciprocity: Is It Present?
(continued)
 The client is focused on his or her own
difficulties or experience, is not able to wish
the therapist well or notice anything
personal about the therapist, and/or does
not have the capacity to acknowledge or
thank the therapist.

Why Knowing the Client’s Interpersonal
Characteristics Is Important
 It is important to be  It is equally important to
aware of how a client’s maintain a reflective
interpersonal consciousness about
characteristics affect the your own reactions to
client’s reactions to the the client’s
therapy process and to interpersonal
yourself as the therapist. characteristics.

Why Knowing the Client’s Interpersonal
Characteristics Is Important (continued)
 It is important to  The last of these tasks is
manage your own closely related to how
behavior to support an one selects and uses the
optimal therapeutic six therapeutic modes.
relationship.

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Chapter 5

Being Client-Centered: Understanding

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 Differentiate the meaning of client-centered

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 Recognize the strengths and complexities of

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 Assess client mode preferences as a means of

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 These include a client’s emotions, behaviors,

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 Situational interpersonal characteristics:

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 Situational interpersonal reactions are likely to

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 Are the result of interruptions in . . .

 The impairment experience may involve:

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These experiences and consequences may

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 These are normative and common reactions

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 The client’s natural predisposition toward

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 If a client’s communication style is

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 Strength – The client’s communication is

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 Place yourself in the role of a client. Reflect

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 May provide a window into one’s emotional

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 Speaking slightly but noticeably louder or softer

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 Strength – The client exhibits an average or

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 Place yourself in the role of a client. Reflect

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 In an open, relaxed, or neutral posture, the

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 Anxiety may be reflected by stiffness, quick

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 Strength – The client exhibits an open, relaxed,

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 Place yourself in the role of a client. Reflect

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 Affect reveals one’s outward expression of

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