5.B.2
Adapting your professional behavior to the person and the setting
Énoncé de compétence 5.B.2 d’ASPPB : Adapt one’s professional behavior (e.g., eye contact, speech) based on active self-reflection, guidelines, and an understanding of the influence of social, cultural, or organizational contexts
Good intentions do not travel unchanged across cultures, ages, abilities and settings. Psychologists adjust eye contact, speech, pace, self-disclosure and the medium they work in, guided by self-reflection, professional guidelines and the client's own norms, while keeping the purpose of the work fixed. The aim is that the client receives the respect and attention the psychologist intends, not only that the psychologist feels respectful.
Notions clés
- Eye contact and display norms
- Cultural norms shape eye contact. In one experiment, Japanese participants rated a face making eye contact as angrier, less approachable and more unpleasant than Finnish participants did, although basic physiological orienting to eye contact was similar, pointing to learned display rules.
- Speech without talking down
- Adjusting speech should not slide into over-accommodation. Elderspeak, infantilizing talk directed at older adults, was followed by resistiveness to care about twice as often as normal talk (probability .55 versus .26) among nursing home residents with dementia.
- Self-disclosure
- In a qualitative meta-analysis of 21 studies, therapist self-disclosure was most often followed by a stronger therapy relationship, improved functioning, insight and overall helpfulness. The authors' recommendations favor judicious, purposeful use rather than disclosure by habit.
- The medium of contact
- The 2024 APA telepsychology guidelines include competence with the technology, informed consent, clinical best practices and emergencies. A systematic review found little difference between telephone and in-person therapy in alliance, disclosure, empathy or attentiveness, though telephone sessions were shorter.
Exemple commenté
After moving to a farm with poor internet, a client in the fourth month of therapy for anxiety asks to continue by telephone. The psychologist has relied on the client's face to judge when to slow down and worries the work will suffer without it.
- Reflect on the worry before acting on it: it comes from the psychologist's habits, and comparative studies show little loss of alliance, disclosure or empathy by telephone.
- Check the guidelines: confirm competence with the medium, update informed consent for telephone sessions, and agree on plans for emergencies and dropped calls.
- Replace visual cues with spoken ones: summarize more often and ask directly about pauses, for example, "What was that pause like for you?"
- Watch session length, since telephone sessions tend to run shorter, and ask the client after a few weeks how the change is working.
Adapt behavior to what a setting removes, guided by evidence, guidelines and the client's feedback rather than by one's own discomfort.
Vérifiez vos acquis
What did a systematic review of comparative studies find about telephone versus in-person psychological therapy?
Sources
- Akechi, Senju, Uibo, Kikuchi, Hasegawa and Hietanen (2013), Attention to eye contact in the West and East: autonomic responses and evaluative ratings, PLoS One (PMID 23516627), Abstract: similar physiological responses; cultural differences in evaluative ratings; display rules
- Williams, Herman, Gajewski and Wilson (2009), Elderspeak communication: impact on dementia care, American Journal of Alzheimer's Disease and Other Dementias (PMID 18591210), Abstract: definition; probabilities of resistiveness after elderspeak and normal talk
- Hill, Knox and Pinto-Coelho (2018), Therapist self-disclosure and immediacy: a qualitative meta-analysis, Psychotherapy (PMID 30335457), Abstract: 21 studies; processes following self-disclosure; judicious use
- APA (2024), Guidelines for the Practice of Telepsychology; topics as listed in Perle and colleagues (2026), A compendium for the 2024 APA Guidelines for the Practice of Telepsychology, American Psychologist (PMID 40875352), Abstract: the 11 guideline topics (competence, informed consent, clinical best practices, emergencies)
- Irvine and colleagues (2020), Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies, Journal of Affective Disorders (PMID 32090733), Abstract: results (15 studies)