Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Hands Heal Chapter 1 Communication and the Therapeutic Relationship

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Body of Knowledge: Key components of the therapeutic relationship Confidentiality Personal and professional boundaries –Impact of personal self-disclosure –Dual relationships –Transference/counter-transference Body Language: reading theirs, being aware of yours Understanding impact of trauma/shock

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins BOK Therapeutic Relationship continued Therapeutic environment –Empathy –Attunement Altruism –Nurturing –Compassion –Equal worth

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Interviewing Skills Develop a relationship Gather information Identify goals for health Choose and implement a treatment plan Evaluate progress, integrate feedback, modify treatment plan

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Develop Relationship: Interpersonal Skills Manifest trust and respect Be present, awake, aware and receptive Practice: –Self-awareness –Self-acceptance –Self-regulation

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Develop Relationship: Interpersonal Skills Communication: use silence, ask open-ended questions Practice the following: –Active listening –Confidentiality –Body language –Empathy: compassion, non-judgement, acceptance

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Develop Relationship: Interpersonal Skills Hope: maintain perspective, be consistent and responsive Use the following: –Positive expectations –Visualizations –Humor

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Gather Information Obstacles to gathering information: –Thinking you already know the answer –Being afraid to ask the question Be curious Explore beyond the obvious Accommodate the patient’s style: meet their needs and speak to their level of understanding

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Gather Information: Pre-Interview External image of location, office environment Professional message on phone, website, ads, social media Preliminary phone contact: –Determine fit or refer out –Prepare them for visit (expectations, forms to fill out) –Establish need for additional information (prescription, insurance, etc)

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Gather Information: Interview Establish relationship Review intake forms Confirm medications and allergies Reflect patient’s goals for health and priorities for session Explore past/concurrent treatments Expand on presenting symptoms Discuss a preliminary treatment plan

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Gather Information: Hands-on Interview Permission to touch: explain intent Verbal and non-verbal information gathering Visual observations Palpation findings Movement tests

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Gather Information: Post-Interview Summarize findings Confirm findings with patient

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Identify Goals for Health Understand and support patients goals for health Prioritize goals for session Construct functional goals –Based on current limitations regarding specific activities of daily living (ADLs) –Measurable (quantifiable and qualifiable) –Set in time (by when will patient accomplish goal)

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Choose and Implement a Treatment Plan Identify treatment goals (e.g., reduce inflammation, reduce pain, increase ROM) Select treatment options to accomplish goals (e.g., lymphatic drainage, ice packs, resistive stretching) Select self-care strategies to assist in accomplishing functional goals (e.g., ice packs, self-massage, isolated stretching)

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Evaluate Progress, Integrate Feedback, Modify Treatment Plan Compare results of pre and post assessment Summarize observations Confirm treatment plan with patient –Were goals accomplished? –Was treatment effective? –What should continue? –What should change?

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Summary Develop a therapeutic relationship Practice interpersonal skills Maintain an open line of communication throughout: –Information gathering –Identifying goals for health –Choosing and implementing a treatment plan –Evaluating progress, integrating feedback, and modifying the plan