Therapeutic relationship in pediatric physiotherapy

Abstract

Rationale: In therapy a positive patient-therapist relationship between client and therapist is an important prerequisite for reaching therapeutic goals. It is also known to be a key determinant for progress in therapy. In psychotherapy effects of this relationship have been studied extensively. Concerning pediatric physiotherapy, only studies are available how to collaborate in therapy with child and parent in a model of Family Centred Care. However, in pediatric physiotherapy no research has been conducted into the process and topics affecting the therapeutic relationship. To gain insight of the therapeutic relationship in pediatric physiotherapy, more knowledge is needed about perceptions, experiences and preferences of the therapeutic relationship according to child, parent and child therapist. Purpose: To explore the therapeutic relationship in pediatric physiotherapy from the perceptions, experiences and preferences of child, parent and therapist. Methods: In a qualitative study based on the Grounded Theory, five children, their parents and therapists from the department pediatric rehabilitation of a local hospital in The Netherlands, served as respondents during in-depth interviews. After the interviews, a treatment of each child was observed in order to collect additional data. Qualitative analysis was performed in a cyclic process. Results: Complementary and mutual reinforcement in the therapeutic relationship emerged as a central theme. This theme consisted of four common themes: (a) trust in the characteristics and in the attitude of the therapist, (b) trust in the quality of care, (c) collaboration between child, parent and therapist, and (d) sharing of information between child, parent and therapist. Trust in the characteristics and in the attitude of the therapist was the most important theme. The results indicate that it is important for therapists to know the needs and preferences of the children and their parents to strenghten the therapeutic relationship. Conclusion: This study provides a first insight in the therapeutic relationship in pediatric physiotherapy by a description of a central theme, complementary and mutual reinforcement in the therapeutic relationship. This information can assist therapists working with children and their parents to strenghten the therapeutic relationship. More research is needed to get a more complete insight in the therapeutic relationship in pediatric physiotherapy.