Therapeutic Use Of Self: Adult And Geriatric Disease States


Therapeutic Use of Self (TUS) involves the conscious attempt by the therapist to understand how the patient is feeling and what they are experiencing in their life and disease state. Hence, the successful application of TUS requires that the therapist have a high-level of self-awareness and consciousness of basic philosophy, when interacting with their patient. The report presents the rationale that indicates; successful application of TUS by the therapist will aid them to craft therapy plans, and enhance the effectiveness of interventions.

Introduction – Overview of Therapeutic Use of Self

The practices that are designed in health care interventions are usually associated by laypersons with treatment of the ailing patient via drug products or via tangible exercise practices. However, drug interventions are certainly not the only means of treating or caring for a patient and this is especially true in Occupational Therapy. Occupational therapy may be defined as “a form of therapy that encourages rehabilitation of activities required for daily life in which the care-giver attempts to relate to the patient, often applied to those recuperating from physical or mental illness,”. Hence, the particular set or standard of interventions will be specific to the needs of the particular patient. For instances where treatment will rely on more than just drug interventions an approach of quality of care from environmental and mental improvement may occur. As an example, data indicates that the methods for which a nurse practitioner utilizes during their delivery of care to the patient may actually aid in the healing process. The application of theory that relies on improving the environment (i.e. surroundings) of the patient will place the patient in a more improved state of mind and this (in some cases), actually improves their prognosis. One specific concept of therapeutic application, which has been embraced by occupational health specialists, is known as “Therapeutic Use of Self, (TUS)”. The term may be defined when referring to “the therapists’ conscious effort to optimize their interactions with clients,”. TUS is centered on controlling the events that occur after a certain action. In practice, TUS therapy is applied when the healthcare practitioner or designated individual performs an action with a patient. These actions are also specifically designed to help produce a certain reaction of therapeutic benefit within that patient. In order to better understand the use of TUS in practice, this report will highlight the use of TUS in the field of geriatrics. Elderly patients are of particular benefit with this practice due to the fact that they are at the Late Adulthood stage of their life span. At this point exercising mental control for that individual is known to help them improve their cognitive functions and in some cases will also aid in the process of improving motor functions. In addition to covering the disease state in the geriatric population, additional examples of applying TUS to therapies for common (and uncommon) adult disease states, will be considered and described. Finally, it is noted that the overall intent of this report is to produce thought provoking data and information on TUS applications, with the hope of further implementation in actual practice.

Understanding TUS Role in Adult / Geriatric Disease States

The adult and geriatric disease states that can be treated with the application of TUS include (but are not limited to): Dementia, Alzheimer’s, Depression, Parkinson’s, Anxiety, Panic Disorder, and more. While these previously stated disease states are all of mental and cognitive origin, the practice can also be utilized to better understand the patient and thus for treating: Diabetes, Coronary Heart Disease, Arthritis, Incontinence, and more. It is noted that TUS relies heavily on the interaction between the therapist and the client and that the successful utilization of TUS will allow the therapist to design more effective interventions for the patient. As the occupational therapist decides how to design their patient’s intervention plan, TUS should be employed at the onset for ensuring successful rehabilitation of their patient. The therapist may perform an assessment of the patient’s disease state, and prognosis and gain a better understanding, if they place themselves in the shoes of the patient in a self-conscious manner. The therapist may begin his/her procedures by first performing a mental assessment of the patient when applicable. Information that has not been determined within the clinic and/or primary care site may be obtained through methods of interviewing and surveying the patient. For instances when the adult or geriatric patient is suffering from mental health conditions, the cognitive assessments are often more important than assessments of motor skills. Patients with disease states such as Dementia or Depression may undergo counseling assessments with the occupational health therapist. The benefit will actually be on both ends of the spectrum for such assessments. The therapist may craft questions that challenge the individual to take a TUS stance on their care. The questions should alert the individual and should trigger feelings of self-identification. The key components of TUS include allowing the patient to feel that he/she is in control of the actions that occur around them. Subsequently, the trick for the therapist is to understand his/her patient in order to determine which actions will yield the desired response. These assessments that are intended to profile the patients should be conducted in a manner that does not make the patient feel as if he/she is the subject of a study, more or less, the therapist should make attempts to make a personal connection to the patient as this helps (in many cases) to ease the mind of the patient. Hence, after the assessment of personality (I.e. Psych assessment) is made, by the therapist’s conscious attempt to build a firm client-patient relationship, the therapist may begin to apply the procedures of TUS.

Applying the procedures of TUS - Mental Illness Disease States

It is at this point in practice that the skills of the therapist are brought into play. The therapist must utilize his/hers own ability to gain a full awareness of what that patient is going through. Thus, TUS may not be applied in instances when the patient does not have a high-level of trust for the therapist. Some methods that may aid the therapist to gain trust include applying; Respect, Genuineness, and Empathy. TUS is an interesting concept in dementia and depression disease states as it may not be easy for the therapist to fully comprehend what it is that the patient is going through. Depression patients will often feel as if they are alone in their struggle and it is particularly difficult to gain the trust of these troubled individuals. The most effective method that may be applied to gain the trust of these patients is to empathize with them. Under no circumstances should therapists utilize any procedures that make the patient feel as if they are inferior or wrong for feeling the way they do. If this is to occur, then it is likely that TUS will not be able to occur for these situations, and the therapist must then design the interventions without the use of TUS. It is also important to note that TUS is not only performed at the onset of the intervention design process. On the contrary for mental disease states the therapist should utilize TUS practices during each intervention. It therefore remains important for the therapist to maintain a high-level of self-awareness, self-understanding, and understanding related to the overall human condition.


In summary, TUS does not provide any defined procedures for any particular intervention. Instead, it allows the therapist to identify with the patient in a conscious manner and therefore better understand the patient, with respect to the patients overall life and disease state. The most critical attributes that should be performed when applying TUS to assessments and interventions is that the therapist must keep a firm sense of self-awareness, and self-understanding. The therapist must also maintain a philosophical understanding of life and death, as this will aid in particular with patients that have experienced a traumatic event and/or are of advanced age. Some adult and geriatric disease states that benefit the most from utilizing TUS are; Dementia, Alzheimer’s, Depression, Parkinson’s, Anxiety, Panic Disorder, as well as, Diabetes, Coronary Heart Disease, Arthritis, and Incontinence, for which the latter set of disease states will have a cognitive impact on the patient (triggering the purported use of TUS). In the future, it is likely safe to assume that TUS will be employed in a more holistic manner and will encompass many more disease states that are not limited to the patient’s mental and/or cognitive state.

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