The patient-therapist relationship in occupational therapy has been a blend of competence and caring with the emphasis fluctuating over the years between these two features. When patients tell stories about their experiences, they reveal widely differing views of occupational therapists, partly because of the different ways therapists manifest competence and caring during patient-therapist interactions. Images from stories suggest that some therapists unwittingly disappoint their patients. This paper examines the patient-therapist relationship as envisioned by therapists and patients to help occupational therapists recommit to the patient as a vital partner in a collaborative relationship.
Seven core values are said to undergird the profession of occupational therapy, with empathy serving as a hallmark of one of those values-personal dignity. This inquiry explores the meaning of empathy within a practice that holds occupation at its center. The literature on empathy in both philosophy and the behavioral sciences yields cogent thoughts about the fullness of empathy and its characteristics actions. The Healing Heart, the biography of a pioneer therapist, Ora Ruggles, shows the manner in which occupational therapists can be empathic in their practice. These reflections and illustrations serve to sharpen the vision of occupational therapists as persons who reach for both the hands and the hearts of others.
The art of practice in occupational therapy is intrinsically centered on relationships, on the qualities that make relationships meaningful, and on the meaning of occupation in a life. Demands from today's health care system make it increasingly difficult for practitioners to engage in meaningful relationships with their patients. The art of practice, jeopardized by the health care system, requires sustenance from other sources. A new field, literature and medicine, suggests a source of sustenance for the art of occupational therapy practice. The reading of fictional literature can provide occupational therapists with sustaining images that can reaffirm their commitment to the art of providing occupation as therapy.
Occupational therapists who would better understand and advocate against depersonalization in health care can find specific references in narratives to the attitudes and behaviors that seem problematic. Patients argue that helpers fail to recognize that illness and disability are events charged with personal meaning. Instead of communicating with patients, helpers establish a distance that diminishes them. They withhold information in a manner that precludes hope, they use brusque manners, and they misuse their powers. Each of these behaviors seems unreasonable and impersonal, and each discourages patients. Together these narratives might inspire therapists to value interactive reasoning as central to practice, to recommit to their consideration of persons, and to enact a climate of caring.
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