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Using the Intentional Relationship Model in Occupational Therapy Research, Education, and Practice

Goal: In Oslo, Norway, the IRM model has been used in the occupational therapy education since 2011. The Self-Assessment of Modes Questionnaire was reently translated into Norwegian (N-SAMQ), and studies of mode preferences in therapists and students are in progress.

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Tore Bonsaksen
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Purpose: The purpose of this paper is to investigate psychometric properties of the Self-Efficacy for Therapeutic Use of Self (SETUS) scales, a questionnaire based on the Intentional Relationship model, and to investigate the factor structure and internal consistency of the English version of three-part SETUS questionnaire in occupational therapy students. Design/methodology/approach: The sample of this cross-sectional study included 155 students with age range 18-30 years, of which 95% were women. Principal Components Analysis (PCA) was performed on the questionnaire scales, including the Self-Efficacy for Therapeutic Mode Use (SETMU), Self-Efficacy for Recognizing Interpersonal Characteristics (SERIC) and Self-Efficacy for Managing Interpersonal Events (SEMIE). The internal consistencies were calculated. Pearson correlation analysis was used to evaluate the strength of correlation among the scales. Findings: The PCA confirmed that the items of each of the three proposed scales loaded strongly on one factor (self-efficacy for three factors of therapeutic mode use, recognizing interpersonal characteristics and managing interpersonal events). The Cronbach's alpha for the SETMU, SERIC and SEMIE was 0.85, 0.95 and 0.96, respectively. The three scales significantly inter-correlated strongly (r ranging 0.74-0.83, all p < 0.001). Originality/value: The SETUS questionnaire comprises three valid and reliable scales. It can be used by occupational therapy supervisors as a means to reflect on students' self-efficacy in components of therapeutic use of self.
Tore Bonsaksen
added a research item
Previous research has shown that occupational therapists have increased their self-efficacy for using self intentionally in therapeutic encounters. However, experiences related to such changes have not yet been explored. The authors developed a therapeutic use-of-self training workshop to support the confidence and competence of practicing occupational therapists in using the Intentional Relationship Model and possibly enhancing their self-efficacy for therapeutic use-of-self. The purpose of the study was to explore the experiences of practicing occupational therapists in transferring learning from a training workshop focused on the therapeutic use-of-self into real world practice. Thirteen occupational therapists participated in the workshop and subsequently completed between one and four reflection notes. These notes were subjected to qualitative thematic analysis. The findings were organized into four themes: therapeutic relationship reasoning, engrained previous learning, reflection on/in action, and level of skills in conducting reflection. Reflection skills seemed to be essential for establishing and developing therapeutic relationships; practicing such skills needs to be facilitated by the work environment through emphasis on reflective practice and mentoring.
Tore Bonsaksen
added a research item
Subsequent to the introduction of the Intentional Relationship Model (IRM) in 2008, two IRM-related research projects have been carried out in Norway. The purpose of this paper is to report on the findings from both projects to a Norwegian audience, and to discuss interpretations and implications of the findings. Studies from Project 1 found that occupational therapists and occupational therapy students differed with regards to their preference for therapeutic modes. Studies from Project 2 found that occupational therapy students increased their self-efficacy for using therapeutic modes, for recognizing clients’ interpersonal characteristics and for managing interpersonal events. Improvements were significant at short-term and long-term follow-ups. While the findings may be interpreted in different ways, varying levels of maturity and experience as a therapist may contribute to explain different preferences for mode use between therapists and students. The education programs, including seminars with skills training focused on the therapeutic use of self, and perhaps most importantly the practice placements, appear to increase students’ self-efficacy for using self as a tool in future therapeutic encounters.
Tore Bonsaksen
added a research item
Background: Research suggested combining modern test theory with classical test theory to achieve comprehensive evaluation of an assessment tool. However, the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire has not yet been examined by the modern test theory. Aims/objective: This study aims to examine psychometric properties of the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire by using Rasch analysis. Material and methods: One hundred and eleven occupational therapy students from two universities in Norway completed the questionnaire across four time points. Rasch analysis was used to examine the appropriateness of the rating scales, unidimensionality, person response validity, item/person separation, and the Wright map. Results: The ten-point rating scale did not fully maximise the measurement potentials. Unidimensionality was confirmed except for two items. Person response validity needs further investigation. Excellent person/item separation and Wright map were found. Conclusion: This study supports the psychometric properties of the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire in assessing self-efficacy in therapeutic encounters. Further research is needed to address the misfit items and the rating scale issue. Significance: Rasch analysis showed that the Norwegian Self-Efficacy for Therapeutic Use of Self questionnaire is promising to be used as a reliable and valid tool.
Tore Bonsaksen
added a research item
Occupational therapy students need to develop self-efficacy for therapeutic use of self in practice. This longitudinal study examined Norwegian occupational therapy students' self-efficacy for therapeutic use of self over a 16-month period and investigated predictors of their end-point self-efficacy. One hundred and eleven students from two universities completed a self-efficacy questionnaire related to the use of self after a workshop, and at 3-month, 10-month, and 16-month follow-up. The students' self-efficacy development was analyzed with linear mixed effect models, while factors associated with self-efficacy were investigated with linear regressions. The students from both universities showed a linear increase in self-efficacy for therapeutic mode use (p < 0.001), recognizing clients' interpersonal characteristics (p < 0.001), and managing interpersonal events (p < 0.001). However, for the students from University 1 the largest increase occurred in an early phase, whereas for the students from University 2 the largest increase occurred in a late phase. Only baseline scores were associated with the end-point measure at 16-month follow-up. The study indicates that students' self-efficacy for therapeutic use of self increased during the follow-up period and adds to the knowledge about occupational therapy students' self-efficacy development related to understanding and managing client-therapist interactions.
Tore Bonsaksen
added a research item
Background/A Skills that enable the maintenance of productive relationships with clients are an essential aspect of therapeutic practice and include the use of therapeutic modes appropriate to clients' needs. The therapist requires a certain level of self-efficacy in order to use therapeutic modes in client–therapist interactions. Recently, a tool was developed to assess therapists' self-efficacy in the use of therapeutic modes. The structure of factors within and internal consistency of the self-efficacy for therapeutic mode use tool was examined. Methods Occupational therapists (n=51) from the UK and Iran completed the self-efficacy for therapeutic mode use assessment tool and provided sociodemographic information. The structure of factors was examined using principal component analysis and parallel analysis; internal consistency was assessed using Cronbach's α and inter-item correlation. Results Parallel analysis suggested that the preferred structure has only one factor, explaining 55.2% of data variance. The items' factor loadings ranged between 0.67 and 0.80, and the scale had a Chronbach α of 0.83. Conclusions The sum of the scale scores can be useful in occupational therapy research and audits focusing on self-efficacy in the use of therapeutic modes in practice.
Chia-Wei Fan
added a project reference
Tore Bonsaksen
added a research item
Introduction/Rationale: The Intentional Relationship Model (IRM) provides concepts for understanding the therapeutic relationship in occupational therapy practice. Two previous studies have focused on therapist communication style, or ‘therapeutic mode’ use, but to date no group comparisons have been reported. Objectives: To explore differences between occupational therapists and occupational therapy students with regard to their therapeutic mode use. Method: The study had a cross-sectional design, and convenience samples consisting of occupational therapists (n = 109) and of second-year occupational therapy students (n = 96) were recruited. The Self-Assessment of Modes Questionnaire was the main data collection tool. Group differences were analyzed with independent t-tests. Results: The occupational therapists responded more with the collaborative and empathizing modes than the students did. The students responded more with the advocating and instructing modes than the occupational therapists did. Conclusion: There appears to be some systematic differences between occupational therapists and occupational therapy students concerning their therapeutic mode use. Some modes, such as the collaborating and empathizing modes, may be viewed as requiring more experience, whereas other modes, such as the advocating mode may be related to more recent rehabilitation ideologies. These factors may contribute to explaining several of the group differences observed.
Tore Bonsaksen
added a research item
Background. Occupational therapy students need to develop self-efficacy for managing the therapeutic relationship in practice. This study examined the 10-month trajectories of Norwegian students’ self-efficacy for use of self. Methods. Eighty-nine students completed self-efficacy questionnaires related to the use of self after a workshop and at 3- and 10-month follow-up. Changes on the three outcome measures (self-efficacy for therapeutic mode use, for recognizing clients’ interpersonal characteristics, and for managing interpersonal events) were analyzed with repeated measures ANOVA. Results. Across the follow-up period, the students improved their self-efficacy for therapeutic mode use (partial 𝜂2 = 0.44, 𝑝 < 0.001), for recognizing clients’ interpersonal characteristics (partial 𝜂2 = 0.81, 𝑝 < 0.001), and for managing interpersonal events (partial 𝜂2 = 0.32, 𝑝 < 0.001). Conclusion. The increased self-efficacy for use of self that was found at 3-month follow-up was maintained at 10-month follow-up.The results indicate that studentsmay experience a boost in self-efficacy for therapeutic use of self after a brief workshop and that these changes can be sustained over time.
Tore Bonsaksen
added 4 research items
Norwegian version of the "Self-Assessment of Therapeutic Modes Questionnaire", originally developed by Renee R. Taylor, Carole Ivey, Jayne Shepherd, Dianne Simons, Jessica Brown, Matt Huddle, Nikki Kardouni, Meagan Kirby, Cody LaRue, and Rachel Steele.
Norwegian version of the "Self-efficacy for managing interpersonal events", originally developed by Farzaneh Yazdani and Kellie Tune, Oxford Brookes University, Oxford, England.
Norwegian version of the "Self-efficacy for recognizing clients' interpersonal characteristics", originally developed by Farzaneh Yazdani and Kellie Tune, Oxford Brookes University, Oxford, England.
Tore Bonsaksen
added a research item
Background: The Intentional Relationship Model addresses the use of different therapeutic approaches according to client needs, but also the therapist’s need to manage the relational challenges that inevitably arise in therapeutic encounters. However, measures of therapist self-efficacy related to managing such challenges have not been previously developed. Aim: This study aimed to examine the psychometric properties of a new measure, the Norwegian self-efficacy for managing interpersonal events (N-SEMIE). Methods: Occupational therapy students (n = 106) completed the instrument along with sociodemographic information. Factor analysis was performed using Principal Components Analysis in combination with Parallel Analysis, and internal consistency was assessed with Cronbach’s α and inter-item correlations. Results: All scale items belonged to the same latent factor (factor loadings 0.72-0.84), and Cronbach’s α was 0.94 (mean inter-item correlation 0.60) for the scale items. Conclusion: The N-SEMIE scale is unidimensional; the items have very high internal consistency; and the scale may be useful in research and audits related to therapist management of the interpersonal aspects of occupational therapy practice.
Tore Bonsaksen
added a research item
Background: The Intentional Relationship Model addresses the use of different therapeutic Approaches according to client needs, but also the therapist’s need to manage the relational challenges that inevitably arise in therapeutic encounters. However, measures of therapist self-efficacy related to managing such challenges have not been previously developed. Aim: This study aimed to examine the psychometric properties of a new measure, the Norwegian self-efficacy for managing interpersonal events (NSEMIE). Methods: Occupational therapy students (n = 106) completed the instrument along with sociodemographic information. Factor analysis was performed using Principal Components Analysis in combination with Parallel Analysis, and internal consistency was assessed with Cronbach’s α and inter-item correlations. Results: All scale items belonged to the same latent factor (factor loadings 0.72-0.84), and Cronbach’s α was 0.94 (mean inter-item correlation 0.60) for the scale items. Conclusion: The N-SEMIE scale is unidimensional;the items have very high internal consistency; and the scale may be useful in research and audits related to therapist management of the interpersonal aspects of occupational therapy practice.
Tore Bonsaksen
added a research item
Introduction Self-efficacy concerned with the therapeutic use of self is important for occupational therapists, and students need to develop the skills and the self-efficacy required to meet interpersonal challenges in practice. This study examined short-term changes in occupational therapy students’ self-efficacy for using therapeutic modes, for recognizing clients’ interpersonal characteristics, and for managing interpersonal events. Factors associated with such changes were also examined. Method A sample of 89 Norwegian occupational therapy students from two universities was used, and the students completed three questionnaires 2–3 weeks after a workshop and at 3 months’ follow-up. Changes on the outcome measures were analyzed with t-tests for dependent samples, and factors associated with the outcome changes were analyzed with linear regression analyses. Results During the follow-up period, the students improved their self-efficacy scores on all three outcome measures. Higher age was associated with more improvement on two of the outcome measures. Conclusion The occupational therapy students improved their self-efficacy for therapeutic use of self during the brief follow-up period. Thus, the time in education, either university-based or practice-based, seems to add to students’ self-efficacy for clinical skills in this area. Higher age appears to be a resource for gaining more self-efficacy from attending educational courses.
Tore Bonsaksen
added a research item
Background: The Intentional Relationship Model (IRM) proposes six distinct ways of relating to clients. A new instrument for measuring self-efficacy for using the therapeutic modes in occupational therapy practice was recently found to have good psychometric properties. To date, however, no research has investigated factors associated with self-efficacy for therapeutic mode use. Aim: This study aimed to explore sociodemographic and education-related factors associated with self-efficacy for therapeutic mode use in a sample of occupational therapy students in Norway. Methods: Occupational therapy students (n = 111) from two education programs completed the Norwegian version of the recently developed “Self-efficacy for therapeutic mode use” (N-SETMU), in addition to reporting sociodemographic and education-related information. Hierarchical linear regression analysis was used to examine factors independently associated with the students’ N-SETMU scores. Results: Higher N-SETMU scores were associated with better average academic performance among the students. Otherwise, none of the associations were statistically significant. Conclusions: As better academic results were linked with higher self-efficacy for therapeutic mode use, the study indicates that some students perform well academically and have high self-efficacy for practical skills, whereas others perform less well academically and have lower self-efficacy for practical skills. A potential transfer of self-efficacy beliefs from one area of performance (academic) to another (practical skills) seems possible, and this may be investigated in future studies.
Tore Bonsaksen
added a research item
Background: In recent years, job satisfaction has become an area of interest within the health professions. Norwegian research on job satisfaction has mainly focused on physicians and nurses, and relatively little research has specifically targeted job satisfaction among occupational therapists internationally. Aim: The study aimed to explore factors associated with job satisfaction, interest and control among Norwegian occupational therapists, and to compare occupational therapists in two geographical areas with regard to these variables. Methods: One hundred and eight occupational therapists from Trondheim (n = 61) and Oslo (n = 47) participated in this cross-sectional study. Data were collected by self-report questionnaires concerned with job satisfaction, interest and control, in addition to sociodemographic variables. Data were analyzed with independent t-tests, Chi-square tests, and regression analysis. Results: Overall, the participants reported high levels of job satisfaction, interest and control. Having more years of higher education and reporting more work-related interest were independently associated with a higher level of job satisfaction. Conclusion: The study suggests that occupational therapists’ job satisfaction can be enhanced by increasing their interest in the job, and by furthering their education.
Tore Bonsaksen
added a research item
According to the Intentional Relationship Model, the use of therapeutic approaches tailored to individual clients’ needs is essential for building therapeutic relationships. This study investigated factors associated with occupational therapists’ preferred therapeutic approaches. One hundred eight occupational therapists were recruited as a convenience sample, and the data were analyzed with linear regressions. Mental health as the field of practice was associated with a stronger preference for use of empathy. More job satisfaction was associated with stronger preference for the instructing mode. Empathy appears to be more commonly used in mental health practice, whereas instructing may be linked with job satisfaction.
Tore Bonsaksen
added a research item
Background: The Intentional Relationship Model (IRM) proposes six therapeutic modes as ways of relating to clients. The Norwegian self-efficacy for therapeutic mode use (N-SETMU) was found to have a one-component structure. However, its items reflect abstract concepts rather than concrete behaviors. Aim: To validate further the N-SETMU by linking its items to the Norwegian client assessment of modes (N-CAM), with 30 items constituting six scales (linked to each mode), possessing concrete, behavioral content. Methods: Occupational therapy students (n = 111) completed the N-SETMU and the N-CAM derived items, along with sociodemographic information. Component structure was analyzed with Principal Components Analysis (PCA), internal consistency of scales with Cronbach’s α, and associations between scale scores with Pearson’s r. Results: All items on all N-CAM derived scales loaded on one latent component, except one item related to problem-solving. After removing this item, the scale functioned appropriately. Cronbach’s α for all N-CAM derived scales ranged 0.88-0.94, and the associations between the N-CAM derived scales and the corresponding N-SETMU items ranged between 0.60 (advocating) and 0.79 (encouraging). Conclusions: In view of the strong associations between the concrete, N-CAM derived scales and the abstract N-SETMU items, this study supports the concurrent validity of the N-SETMU.
Farzaneh Yazdani
added a research item
Background: The Intentional Relationship Model conceptualizes the therapeutic use of self within occupational therapy. To increase motivation for and success in establishing therapeutic relationships, therapists need self-efficacy for using the self in therapeutic practice. However, attempts to combine this model with self-efficacy theory are rare, and instruments by which to measure self-efficacy for therapeutic use of self are in a developing stage. Aim: This study aimed to examine the factor structure and internal consistency of the Norwegian Self-efficacy for recognizing interpersonal characteristics (N-SERIC). Methods: Occupational therapy students (n = 100) from two education programs completed the instrument along with sociodemographic information. The factor structure was examined with Principal Components Analysis (PCA), and internal consistency was assessed with Cronbach’s α and inter-item correlations. Results: The PCA revealed that all N-SERIC items belonged to the same latent factor, with factor loadings ranging between 0.75 and 0.89. The internal consistency of the scale items was very high (Cronbach’s α = 0.96). Conclusions: The N-SERIC scale is unidimensional and the items have very high internal consistency. Thus, the scale sum score can be useful for occupational therapy research and audits focusing on interpersonal aspects of practice. Keywords: factor analysis, higher education, psychometrics, reliability, students
Tore Bonsaksen
added a research item
Ergoterapeuters praksis retter seg mot å muliggjøre et hverdagsliv med ønskede og viktige aktiviteter for alle. Psykiske helseproblemer fører ofte til vansker med å delta i aktiviteter, grupper og samfunnsliv, og mange ergoterapeuter har derfor psykisk helsearbeid som sitt arbeidsfelt. En kjernekompetanse for å kunne utføre slikt arbeid er evnen til å etablere, utvikle – og ikke sjelden reparere – relasjoner til klienter. Dette kapitlet presenterer en forståelsesmodell for den terapeutiske relasjonen som er spesielt utviklet med tanke på ergoterapeuters praksis. Vi beskriver og gir eksempler på hvordan terapeuten kan relatere seg til klienten på ulike måter, og viser hvordan hendelser i terapi kan føre til et behov for at terapeuten nettopp endrer sin væremåte. Kapitlet avsluttes med en oversikt over sentrale forskningsbidrag som til nå er knyttet til modellen, og gir retning til fremtidige studier på området.
Tore Bonsaksen
added a research item
Background: According to the Intentional Relationship Model (IRM), the intentional use of relational approaches in therapy (therapeutic modes) is essential for obtaining successful relationships to clients. There have been no attempts to combine the IRM with self-efficacy theory, and instruments for measuring self-efficacy for therapeutic mode use are lacking. Aim: This study aimed to examine the component structure and internal consistency of the Norwegian version of the Self-Efficacy for Therapeutic Mode Use (N-SETMU). Methods: Occupational therapy students (n = 111) from two education programs completed the N-SETMU along with sociodemographic information. Principal Components Analysis (PCA) was performed and component extraction was controlled using Parallel Analysis. Internal consistency was assessed with Cronbach’s α and inter-item correlations. Results: All items on the N-SETMU loaded on the same latent dimension, tentatively called Self-Efficacy for Therapeutic Mode Use. Cronbach’s α for all scales ranged 0.73–0.82. Conclusions: The N-SETMU is a unidimensional measure of self-efficacy for therapeutic mode use in general. The N-SETMU may be a useful tool for occupational therapy research and audits focusing on occupational therapists’ use of therapeutic modes in client interactions.
Tore Bonsaksen
added 2 research items
Background: The Intentional Relationship Model is specifically focused on the relational aspect of therapy. The model describes six therapeutic modes; these represent different types of interaction for the therapist. However, preferences for therapeutic mode use are under researched. Aims: This study aims to describe preferences for therapeutic modes in undergraduate occupational therapy students, as well as to explore factors associated to each of the therapeutic modes. Methods: A sample of 96 occupational therapy students, based at two different Norwegian universities, participated in the study. They completed the Norwegian Self-Assessment of Modes Questionnaire along with sociodemographic information. Descriptive analysis, bivariate correlation and linear regression analysis were employed. Results: The problem-solving mode was most frequently endorsed. There were generally weak associations between the variables, but female sex and being a student in the education program in Trondheim were associated with higher preference for collaboration. Conclusion: There is diversity in students’ preferences for the modes, but the problem-solving mode was the most preferred. Students need to be aware of the mode they feel more comfortable with and make sure they use modes that fit with the specific client. Significance: The occupational therapy education programs need to incorporate raising awareness about therapeutic modes. Keywords: Intentional relationship model, therapeutic relationship, higher education, Norwegian self-assessment of modes questionnaire,
Background: The Intentional Relationship Model (IRM) is a new model of the therapeutic relationship in occupational therapy practice. Two previous studies have focused on therapist communication style, or ‘mode’ use, but to date no group comparisons have been reported. Aim: To explore differences between occupational therapists and occupational therapy students with regard to their therapeutic mode use. Methods: The study had a cross-sectional design, and convenience samples consisting of occupational therapists (n = 109) and of second-year occupational therapy students (n = 96) were recruited. The Self-Assessment of Modes Questionnaire was the main data collection tool. Group differences were analysed with independent t-tests. Results: The occupational therapists responded more within the collaborative and empathizing modes than the students did. The students responded more within the advocating and instructing modes than the occupational therapists did. Conclusion and significance: There may be systematic differences between occupational therapists and students concerning their therapeutic mode use. Some modes, such as the collaborating and empathizing modes, may be viewed as requiring more experience, whereas other modes, such as the advocating mode may be related to more recent rehabilitation ideologies. These factors may contribute to explaining several of the group differences observed.
Tore Bonsaksen
added 2 research items
The Intentional Relationship Model (IRM; Taylor, 2008) was first taught to occupational therapy students in Oslo, Norway, in the fall of 2012. This model focuses on the therapeutic relationship with the client in an occupational therapy context (Bonsaksen, Vøllestad, & Taylor in review). Following an investigation of the students’ preferred therapeutic style (Bonsaksen, in review), some students have wanted to explore the model and its possible utility in mental health practice settings. During the spring of 2013, two students undergoing mental health placement use the IRM as a conceptual framework for their clinical reasoning activities. Their IRM reflection notes are sent to the two faculty members. The notes contain descriptions of interpersonally challenging interactions. The students describe their process of identifying and managing the event; their reasoning concerning their therapeutic style; their shifting or continuing therapeutic style, and the client’s way of responding. During placement, the students meet with the faculty for feedback at three occasions. The presentation aims at 1) illustrating how the IRM can be used as a conceptual framework for occupational therapy students’ clinical reasoning activities during practice placements, and at 2) describing experiences of students and faculty related to their mutual learning process.
Modellen for tilsiktet samspill (IRM) beskriver interpersonlig resonnering som en betegnelse for terapeutens oppmerksomhet og tenkning om relasjonelle hendelser som oppstår i terapien, om klientens reaksjoner på hendelsene og om terapeutens egne reaksjoner og væremåter. De sentrale elementene i IRM er nylig presentert i Ergoterapeuten, men til nå foreligger det få publiserte beskrivelser av hvordan man kan bruke modellens begreper knyttet til interpersonlig resonnering i ergoterapeutisk praksis. Gjennom en periode med studentpraksis i 2013 utforsket to studenter dette spørsmålet i samarbeid med to av lærerne ved ergoterapiutdanningen i Oslo. Artikkelen beskriver og diskuterer to eksempler fra praksis som tar utgangspunkt i deres erfaringer med å bruke IRM som et redskap for klinisk resonnering over situasjoner i praksis.
Tore Bonsaksen
added 4 research items
Introduction: The occupational therapy profession has a long tradition for highlighting the role of the client-therapist relationship for the outcomes of occupational therapy. Despite its perceived value and significance among practicing therapists, a consistent theoretical framework for addressing the therapeutic relationship in occupational therapy practice was not published until 2008. Aim: This article introduces the Intentional Relationship Model, a model which conceptualizes the relational aspects of importance to occupational therapy practice. Outline of the model: Particular emphasis is placed on describing the therapist’s tasks and demands for establishing and sustaining a productive relationship with the client. These demands concern the learning and utilizing of a range of interpersonal skills; the flexible and self-reflective use of six therapeutic modes; and the process of reasoning about the interpersonal events of therapy and how these can be appropriately addressed. Discussion and implications: In the future, the concepts and the practical usefulness of the model will have to be addressed in research, education, and clinical occupational therapy practice.
Background: Worldwide, occupational therapy has emphasized the importance of a positive client-therapist relationship for the outcomes of therapy. A consistent theoretical framework for addressing the relational aspects of occupational therapy practice was published with Taylor’s Intentional Relationship Model (IRM) (1). Educational Philosophy or theory: The IRM acknowledges that all occupational therapists prefer certain types of therapeutic responding, whereas other ways of responding is less developed and may feel uncomfortable. However, the therapist’s therapeutic responding needs to be in accordance with the client’s current needs. Thus, occupational therapists and students are challenged to develop their skills in therapeutic responding to be able to provide better assistance to more clients. Pedagogy/educational approach(-es) used: During the last years, the IRM has been taught to occupational therapy students in Oslo and Copenhagen. Furthermore the students complete the Self-Assessment of Modes Questionnaire to become familiar with their personal therapeutic style when becoming occupational therapists. Evaluation: The students showed interest in using the model in subsequent fieldwork and the clinical supervisors has also shown interest in learning more about the IRM. Application to Education and /or practice: The IRM is expected to have an increased impact on practice, as students and clinical supervisors become familiar with the model. This could also be supported by further research in the topic.
Bakgrunn: Ergoterapifaget og -profesjonen har lang tradisjon for å vektlegge betydningen av forholdet mellom klient og terapeut. Den nylig utviklede modellen for tilsiktet samspill (IRM) introduserte seks terapeutiske modi som ulike måter å forholde seg på i relasjon til klienter. Mål for prosjektet: Prosjektet er en empirisk undersøkelse av studenter i ergoterapi og deres preferanser for seks ulike terapeutiske modi i en rekke hypotetiske praksissituasjoner. I tillegg undersøkes sammenhenger mellom studentenes tilknytning til de ulike modiene. Metode: Tverrsnittsstudie hvor data er hentet med bruk av Self-Assessment of Modes Questionnaire blant 31 studenter i ergoterapi. Data ble analysert deskriptivt, med korrelasjon, og med variansanalyser for gjentatte målinger (repeated measures ANOVA). Resultater: Studentene hadde sterkest preferanse for modusen ‘problem-solving’ og hadde svakest preferanse for modusen ‘advocating’. De som hadde sterkere preferanse for modusen ‘problem-solving’ hadde svakere preferanse for modusen ‘collaborating’. Konklusjon: IRM er en relativt ny modell for ergoterapipraksis, og denne studien er så langt den andre empiriske undersøkelsen som rapporterer bruk av terapeutiske modi. Resultatene var til dels forskjellige fra den andre foreliggende undersøkelsen på området, og årsaker til dette kan relateres til forskjeller mellom utvalg og praksiskulturer. Gitt betydningen av å ha et reflektert og intensjonelt forhold til sin egen terapeutstil peker resultatene mot noen ressurser og muligheter, men samtidig mot noen mulige utfordringer, knyttet til deltakernes preferanser for terapeutstil.
Tove Carstensen
added a research item
Background: The Intentional Relationship Model is specifically focused on the relational aspect of therapy. The model describes six therapeutic modes; these represent different types of interaction for the therapist. However, preferences for therapeutic mode use are under researched. Aims: This study aims to describe preferences for therapeutic modes in undergraduate occupational therapy students, as well as to explore factors associated to each of the therapeutic modes. Methods: A sample of 96 occupational therapy students, based at two different Norwegian universities, participated in the study. They completed the Norwegian Self-Assessment of Modes Questionnaire along with sociodemographic information. Descriptive analysis, bivariate correlation and linear regression analysis were employed. Results: The problem-solving mode was most frequently endorsed. There were generally weak associations between the variables, but female sex and being a student in the education program in Trondheim were associated with higher preference for collaboration. Conclusion: There is diversity in students’ preferences for the modes, but the problem-solving mode was the most preferred. Students need to be aware of the mode they feel more comfortable with and make sure they use modes that fit with the specific client. Significance: The occupational therapy education programs need to incorporate raising awareness about therapeutic modes. Keywords: Intentional relationship model, therapeutic relationship, higher education, Norwegian self-assessment of modes questionnaire,
Tore Bonsaksen
added a research item
Background: The Intentional Relationship Model (IRM) introduced six therapeutic modes as ways of relating to clients. By increasing occupational therapists' awareness of modes, and by increasing their skills in using them, therapists may improve their interactions with clients. The Self-Assessment of Modes Questionnaire may assist in increasing awareness of modes. Aim: To describe the process of developing a Norwegian version of the Self-Assessment of Modes Questionnaire (N-SAMQ) and to evaluate its content validity. Materials and methods: A 10-step translation and adaptation procedure was followed. Occupational therapists working in diverse practice areas completed the preliminary N-SAMQ version. Individual cognitive interviews were performed with these therapists in order to examine the comprehensibility and cultural appropriateness of the N-SAMQ. Results: Initially, one item was omitted. Following the pilot study (n = 7), two of the remaining items were modified with a view to increasing their cultural relevance. Otherwise, modifications were made mostly in terms of words and phrasing. Conclusion: The N-SAMQ appears to have good face and content validity. Significance: With the N-SAMQ, Norwegian occupational therapists can assess their preferred therapeutic modes.
Tore Bonsaksen
added an update
Latest article:
Bonsaksen, T., Kvarsnes, H., Eirum, M.N., Torgrimsen, S., & Hussain, R.A. (2016). Development and content validity of the Norwegian Self-Assessment of Modes Questionnaire (N-SAMQ). Scandinavian Journal of Occupational Therapy, 23(4), 253-259. DOI: 10.3109/11038128.2015.1091896
Related articles:
Bonsaksen, T. (2013). Self-reported therapeutic style in occupational therapy students. British Journal of Occupational Therapy, 76(11), 496-502. DOI: 10.4276/030802213X13833255804595
Vøllestad, K., Torgrimsen, S., Öqvist, T., & Bonsaksen, T. (2014). Interpersonlig resonnering – praktisk anvendelse av modellen for tilsiktet samspill. Ergoterapeuten, 57(5), 44-50.
Bonsaksen, T., Vøllestad, K., & Taylor, R.R. (2013). The Intentional Relationship Model: Use of the therapeutic relationship in occupational therapy practice. Ergoterapeuten, 56(5), 26-31.
Bonsaksen, T. (2014). Engaging students in research and inquiry: Issues to consider. International Journal of Therapy and Rehabilitation, 21(3), 108-109.
 
Tore Bonsaksen
added a project goal
In Oslo, Norway, the IRM model has been used in the occupational therapy education since 2011. The Self-Assessment of Modes Questionnaire was reently translated into Norwegian (N-SAMQ), and studies of mode preferences in therapists and students are in progress.