Therapeutic Relationship

In occupational therapy, the interaction between an occupational therapy practitioner and a client is
identified as the therapeutic relationship, which is key for facilitating the healing and rehabilitation
process (OBrien & Hussey, 2011, p. 157). There are many skills used by practitioners to develop a
therapeutic relationship including trust, active listening, and empathy.
Clients who engage in occupational therapy have emotional and physical needs. Occupational therapy
practitioners address both of these needs. The client is viewed holistically, which means that the
practitioners treat the whole person in an individualized way (OBrien & Hussey, 2011, p.158). By
creating a therapeutic relationship, the occupational therapy practitioner can learn to understand their
client and their clients motivations and desires. This allows for the practitioner to develop meaningful
activities for their client. During the intervention process, a client may go through same stages from the
universal stages of loss. Universal stages of loss is defined as denial, anger, bargaining, depression, and
acceptance (OBrien & Hussey, 2011, p.158). The occupational therapy practitioner can help a client by
providing support.
Having a therapeutic relationship with a client is a determining factor for successful or unsuccessful
therapy. The OT will make sure to always assesses their interaction with their client. The process of
using ones interactions for the benefit of another is called therapeutic use of self, which involves
awareness of oneself (OBrien & Hussey, 2011, p.158).
There are many basic principles to therapeutic use of self, including self-awareness, ideal self, perceived
self, and real self. The practitioner learns to develop trust, provide support, active listening, and
empathize (OBrien & Hussey, 2011, p.158). Self-awareness can be described as knowing ones own true
nature; having the ability to recognize ones own behavior and effect on others (OBrien & Hussey, 2011,
p.158). When individuals wish to be free of demands of reality it is described as ideal self. Perceived self
can be described as the aspect of self that others see without the benefit of knowing a persons
intentions, motivations, and limitations (OBrien & Hussey, 2011, p.159). Lastly blending of the internal
and external worlds involving intention and action and also environmental awareness is described as the
real self (OBrien & Hussey, 2011, p.159). It is important for practitioners to have a sense of selfawareness. It allows them to help clients who may be struggling with lack of self-awareness. The
practitioner can teach their clients way to exercise self-awareness by keeping a journal to write down
feelings or participating in group activities.
In developing therapeutic relationships, it is important to involve the ability to develop trust,
demonstrate empathy, understand verbal and nonverbal communication, and use active listening. It is
important that the practitioner develops rapport with their client to allow the client to trust them. Trust
is defined as the client feeling comfortable sharing personal information that may help shape their
therapy sessions (OBrien & Hussey, 2011, p.159). The practitioner develops the trust by always making
sure to listen to the client, following through with plans, and always remembering to put the client first.
These are just a couple ways to develop trust, but there are many ways one can develop trust with
others. Empathy is the ability to place oneself in another persons position and understand the others
experience, the practitioner understands and is sensitive to the thoughts, feelings, and experiences of
the client without losing objectivity (OBrien & Hussey, 2011, p.160). To develop empathy there is many
things. To know a few, one can participate in activities of other cultures, interview others and try to
understand their life views, and reflect upon the stories of clients and peers.

Clients communicate to practitioners by verbal and nonverbal communication. Practitioners who listen
or watch carefully for communication from clients are more effective in developing therapeutic
relationships (OBrien & Hussey, 2011, p.160). Verbal communication is the process of speaking to
others. Verbal communication allows the practitioner to ask questions to help form an effective
intervention plan. It is important to develop communication skills to be able to communicate effectively
with others and not speak to fast or loudly. Techniques to develop communication skills are to seek and
listen to feedback from others, become familiar with your own style of communicating, and practice
using different techniques. Nonverbal communication includes that of facial expressions, eye contact,
tone of voice, touch, and body language (OBrien & hussy, 2011, p.161). Nonverbal communication is
important to recognize. If a client is suffering from a disability that affects their speech, it is important
that the practitioner can identify their nonverbal communication. Their nonverbal communicate if the
client is in pain, happy, or upset. There are many exercises one can do to develop nonverbal
communication. These include communicating with a peer without talking, observe an intervention
session and identify nonverbal communication used, and practice expressing your emotions without
talking.
Active listening is also an important skill an occupational therapy practitioner should learn. A
practitioner actively listens to the client without making judgements or jumping in with advise. With
active listening, the receiver paraphrases the speakers words to ensure that the client understands the
intended meaning (OBrien & Hussey, 2011, p. 161). There are three processes involved in active
listening; restatement, reflection, and clarification. Restatement is where the practitioner repeats the
words of the client as they are heard and is used to encourage the client to keep talking (OBrien &
Hussey, 2011, p.161). Reflection can be described as a response where the purpose is to express in
words the feelings and attitudes sensed behind the words of the sender (OBrien & Hussey, 2011,
p.161). Lastly, clarification is the clients thoughts and feelings are summarized or simplified (OBrien &
Hussey, 2011, p.162). Clarification allows the client to look closer at their thoughts. There are also many
ways to improve techniques to improve active listening. Some of these techniques include role-playing a
variety of interviews, receive feedback from peers, and interview others and ask for feedback.

Works Cited
OBrien, J.C. & Hussey, S.M. (2012). Introduction to occupational therapy. (4th ed.). Saint Louis, MO.
Elsevier: Mosby.