By Ashley R. OTR, MSOT
VSHF Fellow, ‘23
Since I was 14 years old, I knew that I wanted to become an occupational therapist, and when choosing my major for my bachelor’s degree, this was at the forefront of my mind. As I considered the skills required for an occupational therapist to effectively work with patients, I thought that communication was a very important component of effective treatment, and wanted to hone this skill through my education. I selected communication as my major in college with a minor in psychology and, while working on this degree, completed research on communication within the world of occupational therapy. As I have been working in the field of hand therapy as an occupational therapist, I have personally witnessed the importance of excellent communication skills and how this can affect patients on their journey to recovery. I will discuss three main points in this post: 1) the concept of emotional intelligence (EI) and how it relates to the therapeutic use of self, 2) how therapists may develop improved EI through self-reflection, and 3) my insights regarding communication tips that I have found to be helpful when working with patients in a clinical setting.
Emotional Intelligence and Therapeutic Use of Self
Due to the inherently personal nature of occupational therapy, interpersonal communication is certain, and an understanding and proper use of emotions, perceptions, and interactions is important to ensure optimal therapeutic and relational outcomes. Within occupational therapy education, the concept of the therapeutic use of self is emphasized and taught as an important skill to be utilized as a therapist. Within the field of communication studies, a very similar concept of emotional intelligence (EI) exists as well. I petition that these two concepts are interrelated and can be used together to promote better communication and more effective therapy treatment.
In the realm of occupational therapy, effective engagement with the patient is influenced heavily by the therapist’s understanding and utilization of a concept known as the therapeutic use of self. Therapeutic use of self is defined as “practitioner’s planned use of his or her personality, insights, perceptions, and judgments as part of the therapeutic process” (Chaffrey et al., 2011, citing Punwar & Peloquin, 2000). Therapeutic use of self has several components, one of which is emotional intelligence (EI).
There have been many attempts to accurately represent and define the concept of EI, but “researchers concur that this construct involves awareness of one’s own and others’ feelings and emotional management” (Chaffey et al., 2011). EI involves perception and recognition of both oneself and the other person, and the ability to use emotions and feelings to yield constructive outcomes.
To effectively communicate with patients while at the same time regulating their own and their patients’ affective states, therapists must have knowledge of their own and their patients’ emotions, which suggests that EI is an important element of therapeutic use of self (Chaffey et al., 2011). Therapeutic use of self involves using EI to manage the therapeutic process by reflecting and internally processing the interaction, which in turn allows them to communicate interpersonally. As therapists, we can and should channel our own emotions and the emotions that we perceive from our patients into the process of building a successful therapeutic relationship with our patients. Therapeutic use of self and EI are intertwined within interpersonal communication in occupational therapy because of their complementary relationship, similarities, and the emphasis both place upon the ability of the therapist to internally process and adapt according to the situation and emotional responses of both the patient and them to improve the relationship.
Self-Reflection to Improve Emotional Intelligence
I discovered a study that explored developing the skills of emotional intelligence (EI) through self-reflection journals utilized by occupational therapy students (Perkins and Schmid, 2019). This study found that traits of EI were increased in occupational therapy students who utilized short-term self-reflection journals while in school. The journal questions included questions such as “How do your behaviors and actions support what you say and do?” and “Describe a time when your emotions were triggered by the actions of another. Did you recognize your emotional trigger in the moment or later?”. The results of this study suggest that even short-term use of self-reflection journals may have the ability to positively influence trait EI skills of future occupational therapy clinicians (Perkins and Schmid, 2019). This implies that self-reflection is important in the quest to gain EI skills as a person and a therapist or future therapist. It is vital that you understand yourself so that you can channel your thoughts and emotions into positive interactions with others.
Practical Applications/Tips for Communication as a Therapist
As an occupational therapist with a degree in communication, I am sensitive to the impact that my communication with my patients has on their course of treatment and their sessions. I am still learning and growing in my communication skills but have picked up several valuable tips along the way.
1. Self-Reflection. As therapists, we spend a lot of time communicating with and caring for others but to do this to the best of our ability, we need to understand and care for ourselves. Spend time reflecting on yourself and your interactions with your patients to develop improved emotional intelligence and avoid burnout.
2. Be calm and validate your patients. It is important to understand that, while this may just be another day at the clinic for you, your patient is undergoing a major event in their life that may be causing them significant anxiety and stress. It is very important to approach the patient in a calm and validating manner. Acknowledge their pain and ask about how they are feeling.
3. Encourage your patients but ensure that they have realistic expectations. I like to celebrate the “small” wins with my patients and remind them of their progress (sometimes pulling up measurements from a couple of sessions or weeks prior to show them how they have improved). However, it is also important to be honest with your patients and their trajectory in a kind manner and set realistic expectations for them.
4. Work to get to know your patients on a personal level. Ask them about themselves and try to ensure they feel comfortable with you. Of course, keep all topics appropriate and professional but many times it can ease stress and anxiety when conversation is made that involves things that are important to them or things they enjoy.
5. Explain their injury or surgery to your patients in terms that they can understand. If necessary, take time to practice this before explaining it to a patient. For example, when explaining a trigger finger diagnosis to a patient, I try to help them understand their anatomy by describing it as a fishing pole with a fishing line on it, and the little rings that keep the fishing line on the pole are called “pulleys”. Try to think about creative ways to help them understand. When the patients understand what is going on, they are typically much more comfortable and compliant with therapist guidance.
Chaffey, L., et al. “Relationship between Intuition and Emotional Intelligence in Occupational Therapists in Mental Health Practice.” American Journal of Occupational Therapy, vol. 66, no. 1, 29 Dec. 2011, pp. 88–96, ajot.aota.org/article.aspx?articleid=1851545, https://doi.org/10.5014/ajot.2012.001693.
Perkins, Natalie A, and Arlene A Schmid. “Increasing Emotional Intelligence through Self-Reflection Journals: Implications for Occupational Therapy Students as Emerging Clinicians.” Journal of Occupational Therapy Education, vol. 3, no. 3, 1 Jan. 2019, https://doi.org/10.26681/jote.2019.030305.