An Exploratory Study of How Occupational Therapists Develop Therapeutic Relationships With Family Caregivers

Abstract

Family members, who provide 70% to 80% of all long-term care, have often been perceived by occupational therapists as a barrier to, rather than a partner in, effective care for elderly persons. This perception suggests that in order to build effective partnerships to manage complex issues, occupational therapists working with elderly persons must develop effective strategies for involving family members in the therapeutic process. This article describes a pilot study that examined how occupational therapists engage family caregivers of elderly persons receiving home care services. A qualitative descriptive approach was used to explore the behaviors demonstrated by two occupational therapists when working with family caregivers. The findings point to four primary types of occupational therapist-caregiver interaction, categorized as: caring, partnering, informing, and directing. These interaction styles were compared with current literature describing state-of-the-art occupational therapy practices with older adults and family caregivers. An emphasis was placed on examining how therapeutic interactions can evoke different caregiver responses and influence the development and maintenance of collaborative therapeutic relationships. The results of this pilot study can serve as a framework for further exploration of interactive strategies that promote caregiver empowerment and ultimately influence the ability of families to assume responsibility for the long-term care required by many chronically disabled older adults.

Caregivers of Persons with Alzheimer'S Disease

“…''Client-centered practice recognizes the autonomy of individuals, the need for client choice in making decisions about occupational needs, the strengths clients bring to a therapy encounter, the benefits of client-therapist partnership, and the need to ensure that services are accessible and fit the context in which the client lives'' (Law, Baptiste & Mills, 1995, p. 253). Clark, Corcoran, and Gitlin's (1995) recommendation for occupational therapists to help caregivers ''to feel empowered to shape [intervention] recommendations to fit their lifestyles, values, and goals'' (p. 588) is strongly supported by the findings of this study. Clark, Corcoran, and Gitlin's (1995) recommendation for occupational therapists to help caregivers ''to feel empowered to shape [intervention] recommendations to fit their lifestyles, values, and goals'' (p. 588) is strongly supported by the findings of this study.…”

Finding Common Ground With Patients: The Centrality of Compatibility

“…The ideal of collaboration has been articulated in the occupational therapy literature in the model of patient-centered practice (Law, Baptiste, & Mills, 1995). We know, however, from research that has examined therapeutic interactions in occupational therapy, that actual practice many times falls short of this ideal (Allison & Strong, 1994;Clark, Corcoran, & Gitlin, 1995;Helm & Dickerson, 1995;Northen, Rust, Nelson, & Watts, 1995).…”

How Therapists' Conceptual Perspectives Influence Early Intervention Evaluations

“…The conceptual literature emphasizes issues such as the kinds of empathy and caring that therapists need to practice if they are to provide meaningful, satisfying, and personalized care to a patient [13], as well as the effects of depersonalization and lack of communication on patients and their families [14] Practice-oriented literature emphasizes the many ways that therapists think and interact during patient treatment. These include the use of procedural, interactive, and conditional reasoning [5]; narrative reasoning that focuses on the illness experience from the patient's perspective as compared to the medical or disease perspective [4]; and ways that therapists develop therapeutic relationships with patient caregivers and family members [15]. This body of work has used qualitative methods to collect patient-based data to formulate principles for action.…”