IRM Foundations
What does IRM stand for?
Intentional Relationship Model
What is the first step in the interpersonal reasoning process?
Anticipate
Name the six therapeutic modes in the IRM.
Advocating, Collaborating, Empathizing, Encouraging, Instructing, Problem-Solving.
What term describes an OT who dominates the session or finishes the client’s sentences?
Dominating response.
What is the goal of using interpersonal reasoning in OT practice?
To maintain client engagement and build a therapeutic relationship through reflective, adaptive communication.
According to Taylor, what is the main purpose of the IRM in occupational therapy?
To help therapists use self-awareness and communication intentionally to build effective therapeutic relationships.
During which step does the therapist identify interpersonal events and use coping strategies?
Step 2 – Identify and Cope.
Which mode involves supporting the client’s emotional needs during times of stress or loss?
Empathizing.
What is a “parental response”?
When a therapist acts overprotective, infantilizing, or demeaning toward a client.
What coping strategy does Taylor recommend for therapists managing emotional reactions?
Tactical breathing, self-reflection, or reminding oneself that not every interaction will be perfect.
True or False: The IRM is a strict, step-by-step guide to interaction.
False — it’s a flexible framework, not a cookbook.
What does Step 3, “Determine if a mode shift is required,” mean?
Deciding whether to intentionally change your therapeutic mode to better meet the client’s needs.
In the Eberly case, which two modes were used first to help her regain confidence?
Empathizing and Instructing.
What is the danger of defensive responses?
They shift focus away from the client’s needs and justify the therapist’s position instead of fostering understanding.
How can therapists balance interpersonal and activity focusing during sessions?
By addressing emotional needs while engaging in meaningful tasks — using both relational and activity-based strategies.
What are the two main types of therapist focus described in Table 7.1?
Interpersonal focusing and activity focusing.
What is Step 6 of the process?
Gather feedback and strive for mutual understanding.
What is a “response mode sequence”?
A deliberate sequence of therapeutic modes used in response to changing interpersonal events.
When might self-disclosure be appropriate?
Only when it benefits the client therapeutically and is relevant to their situation.
What question could a therapist ask to gather client feedback after an interpersonal event?
“Did my response feel helpful to you?” or “How did that approach work for you?”
Name at least three key capacities therapists must develop to use the IRM effectively.
Reflective capacity, observation skills, active listening, emotional regulation, or clinical reasoning.
What is an “interpersonal event cascade”?
When multiple interpersonal events occur quickly, requiring rapid, intentional mode shifts.
Which three modes might be appropriate for a client who is boundary testing?
Empathizing, Instructing, and Problem-Solving.
How can a therapist’s body position unintentionally create a power imbalance?
Standing over a seated client may be perceived as dominating or intimidating.
How can the IRM help prevent burnout in clinical practice?
By encouraging reflection, emotional regulation, and intentional communication, helping therapists manage interpersonal stress effectively.