Psychology and Behavioural Science: Therapeutic Relationships

Therapeutic Relationships

• A therapeutic relationship is a collaborative association between a healthcare practitioner and a patient, based on mutual respect, trust, and commitment to good clinical outcomes.
• It involves caring and non-judgmental behavior within a safe environment, going beyond disease diagnosis, prescribing, and dispensing medications.
• Other terms used to describe therapeutic relationships include therapeutic alliances, working alliances, helping alliances, helpful relationships, and purposeful relationships.

Importance of Therapeutic Relationships

• Traditional healthcare delivery is often too task-oriented, leaving patients with unmet non-medical needs.
• Recognizing patients' unmet needs is crucial, as healthcare practitioners may be the only social contacts they have.
• Pharmaceutical care requires more intimate caring relationships between healthcare practitioners and patients to act in their best interests.
• Positive therapeutic relationships are expected to predict treatment adherence and positive clinical outcomes.

Elements of Effective Therapeutic Relationships

• Effective communication (information provision and assessment of patients' understanding)
• Shared decision making and shared responsibility for clinical outcomes
• Warmth, friendliness, genuine interest, empathy, and unwavering desire to facilitate and support patients
• Improvements in patient satisfaction, adherence to medical treatment, and improved clinical outcomes

Therapeutic Communication

• Patient-centred, therapeutic engagement that takes into account patients' preferences and values in clinical decision making
• Responding to patient emotions and unmet non-medical needs
• Avoiding labels such as "good", "bad", or "uncooperative" patients, which can hinder future healthcare delivery

Interlocking Therapeutic Relationships

• Multidisciplinary healthcare teams, including doctors, nurses, pharmacists, laboratory personnel, and others, work together to restore health.
• Each healthcare team member has a therapeutic relationship with the patient, and continuity in healthcare delivery requires a combination of inputs from all members.
• Effective and safe healthcare interventions require an informed, engaged patient.

Evolution of Therapeutic Relationships

• There is no magic formula for building effective therapeutic relationships, which require unconditional interest in patients and respect for their uniqueness and diversity.
• Building therapeutic relationships involves trial and error, failures, and corrections.
• Therapeutic relationships can evolve in different patterns, such as stable, linear, quadratic, U-shaped, or V-shaped, and may require flexibility to identify and resolve problems.

Key Messages

• A holistic view of healthcare is needed, involving inputs from all members of the healthcare team, including the patient.
• An effective functional pharmacist-patient relationship is only one of several therapeutic relationships that need to work well to achieve good health outcomes.
• Healthcare delivery should focus on both medical competence and interpersonal human aspects, such as the unmet non-medical needs of patients.

Explore the concept of therapeutic relationships in psychology and behavioural science. Learn about the evolution and importance of therapeutic relationships in healthcare.