An Investigation into Factors that can inhibit a Therapeutic Relationship.
When considering the factors that can inhibit a therapeutic relationship, it is firstly important to establish what a therapeutic relationship is, or what it should be like. According to Philip Burnard, "the main point of working in the health care field is to communicate- (Burnard, 1992, p.1). The realm of communication in general is vast, with countless models and theories. As discussed extensively by Burgoon et al, the communication process very much depends on the purpose of the communication (Burgoon et al, 1994). Opinions on the form that the communication between practitioner and client should take are probably as varied as the individuals involved in therapeutic relationships. A general definition is given by Kagan and Evans, "Professional interpersonal skills require flexible adaptation to changing circumstances and different people in a range of different situations, in pursuit of clear nursing (therapeutic) goals- (Kagan and Evans, 1995, p.1). The goal may take many forms; the important point is that both practitioner and client are clear of the goal from the start and constantly aim for it in the development of the therapeutic relationship. From this starting point, this essay will attempt to identify some of the many factors involved and suggest ways in which therapeutic relationships may be rendered more effective.
Some of the most basic problems in the practitioner/client relationship involve physical barriers to communication. These include factors such as non-verbal communication (body language) and the environment in which the practitioner/client exchanges take place. Morrison and Burnard (1997) list the non-verbal aspects as facial expression, use of gesture, touch, body position, proximity, body movement and eye contact. In order for a practitioner to initiate a therapeutic relationship, she must first set the client at ease: " the physician (practitioner) tries to enter the patient's world, to see the illness through the patient's eyes by behaviour that invites and facilitates the patient's openness- (Levenstein et al, 1989, p.
