house Neuro Orthopaedic Institute
19 North Street, Adelaide City West
South Australia 5000
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One Response to “Contact”

  1. Deborah R. Brandt

    To: David Butler
    From: Deborah R. Brandt
    Re: NOI Notes November 2013, Roller Coaster of Professional Life; “… However the interactional power needs better analysis and understanding …”
    Re: NOI Notes Jan. 2014.
    Lezanne: “… coins the useful phrase, “therapeutic use of self”.
    Helen: “… being a facilitator of change.”


    Your November posting and your recent January follow-up were most welcome. Maybe everyone who keeps asking questions has a similar roller coaster experience, but not everyone who has that experience comes to the conclusion that “I” am one of the variables in treatment. I absolutely agree that the power of our interpersonal behavior needs better analysis and understanding.

    The concept and term “use of self” which Lezanne used, has been in use since at least 1995, please see my references below. PT has paid little attention to this vital aspect of the therapist’s contribution to treatment, which, I suspect, is why you thought she coined the term. We are the link between the science and the patient. The only aspect of treatment that we can ultimately control is how we “use ourselves”. I became acutely aware of this when I was a clinical instructor and found myself introducing that idea to every single student that came to me.

    We can be “… facilitators of change”, as Helen states. Commonly, people who take on that responsibility with people in need of help, spend time seriously reflecting on their own behavior. In school, PT students are rarely made aware of what an important component of treatment they are. I believe that as helping professionals we should acknowledge that it is our responsibility to study ourselves, just as we study the many other modalities of treatment. Then, since nothing works for everybody, each person can decide how to proceed.

    Many ways to study our interpersonal behavior already exist. PTs don’t have to reinvent the wheel. For example, the concepts of transference and countertransference apply to human interaction, not just to psychoanalysis and psychology. We need to have interpersonal behavioral options to choose from, and we need to learn how to choose our most productive option at any given moment. Carol Davis, a PT whose book I reference below, has done an excellent job of presenting these ideas.

    Thank you for bringing up this question, it has long frustrated me. It seems so dumb that, except for discrete individuals, our profession has not examined this issue, or perhaps it has already been considered and discarded. It could make our work richer and more productive. It certainly has enriched mine and given me options I didn’t learn about in school.

    I took Explain Pain, bought the book for me and my doctor, who loved it, and I am planning to attend your presentation on Feb. 13 in Philadelphia. I am drawn to how you think and the interesting questions you propose. I know you are very busy, but because this is so important to me I would appreciate any sort of response. Thank you, Deborah

    Arnd-Caddigan M, Pozzuto R. Use of Self in Relational Clinical Social Work. Clin. Soc. Work J. 2007;36(3):235–243. Available at:
    Curran, K. M., Seashore, C. N., & Welp MS. Use of Self as an Instrument of Change. Proc. Organ. Dev. Netw. Meet. Seattle, Washingt. 1995:69–70.
    Heydt M, Sherman N. Conscious use of self: Tuning the instrument of social work practice with cultural competence. J. Baccalaureate Soc. Work. 2005;10(2). Available at:
    Taylor RR. The Intentional Relationship, Occupational Therapy and Use of Self. Philadelphia: F. A. Davis Company; 2008. Available at: ISBN 10: 0-8036-1365-2
    Davis CM. Patient Practitioner Interaction, An Experiential Manual for Developing the Art of Health Care. Fifth Edit. Thorofare, New Jersey: SLACK Incorporated; 2011. Available at:



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