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ABSTRACT
The purpose of this review was to: (a) explore existing literature regarding the 'therapeutic relationship' in physiotherapy to identify what are considered the core components; and (b) critically appraise the conceptual basis of two commonly used measures of the therapeutic relationship: the Working Alliance Inventory and the Helping Alliance Questionnaire Version Two. A systematic approach to searching was utilised to identify relevant literature. Databases searched included: the Cochrane Library, EBSCO Health Databases, Scopus, Web of Science, and OVID. Sixteen studies were included in the review and key themes reflecting the key components of the therapeutic relationship in physiotherapy were extracted from each study. Eight key themes were identified including: patient expectations; personalised therapy; partnership; physiotherapist roles and responsibilities; congruence; communication; relationship/ relational aspects; and influencing factors. Each of the measures addressed some components of therapeutic relationship well (namely congruence, partnership, and physiotherapists roles and responsibilities), while some components were poorly addressed (communication, personalised therapy, and relational aspects). Future research could work towards the development of a more conceptually sound measure of therapeutic relationship for use in this context. In the absence of such a measure, further examination of the measurement properties of existing measures in the physiotherapy setting would be warranted.
Besley J, Kayes NM, McPherson KM. Assessing therapeutic relationships in physiotherapy: literature review. New Zealand Journal of Physiotherapy 39(2) 81-91.
Key words: therapeutic relationship, therapeutic alliance, working alliance, physiotherapy, physical therapy
INTRODUCTION
In many areas of health care, particularly psychotherapy and related fields, the development of a therapeutic relationship or working alliance has been established as a key component for successful treatment outcomes (Leach 2005, Roberts and Bucksey 2007, Schonbergeret al 2006). For example, m psychotherapy it has been stipu ated that the psychotherapistclient relationship determines the effectiveness of psychotherapy more than any other factor (Roberts and Bucksey 2007). However, despite the fact that a 'therapeutic relationship' is considered to be important, there is a paucity of literature regarding this concept within the field of physiotherapy (Bellner 1999, Leach 2005, Potter et al 2003a, Potter et al 2003b, Roberts and Bucksey 2007, Williams and Harrison 1 999). Several authors (Potter et al 2003a, Potter et al 2003b, Roberts and Bucksey 2007) have reported that the therapist-patient relationship is underexplored in physiotherapy, and...