The therapeutic relationship within the patient-caregiver-physiotherapist triangle in the rehabilitation of neurological diseases

Abstract

Objectives

The relationship between patient and physiotherapist increases in complexity when patients experience chronic disability and require caregiver assistance at home. Since relatives often support therapeutic activities, they too play an important role that may significantly influence therapy success. This study reconstructs the therapeutic relationship triangle of patients, caregivers and physiotherapists in neurorehabilitation and seeks to examine how these relationships influence the rehabilitation process.

Methods

A qualitative triangulation study consisting of participant observations and group discussions with long-term affected patients, their family caregivers and physiotherapists were realised. Data were analysed and triangulated using the documentary method.

Results

Two patient types were identified: the optimistic, success-motivated patient type and the pessimistic type. Regarding relatives, a confident, hopeless and a sceptical type emerged. The types differ in their expectations, hopes and desires in therapy. This fundamentally affects the therapeutic relationship triangle.

Discussion

Differing expectations of patients and their relatives should be recognised and taken into account by physiotherapists, as a successful triadic relationship is a prerequisite for effective therapeutic measures. The involvement of relatives in the therapy process plays an important role in achieving therapy goals. More attention should be placed within the triad, in future research and in clinical practice.

Keywords:

• Neurological rehabilitation
• therapeutic alliance
• physiotherapeutic relationship
• triangle relationship
• family caregivers
• physiotherapeutic role

Author contributions

A. von Bosse: Conceptualisation, theoretical background, Methodology, Data curation, Formal Analysis, Writing – original draft.

C. González-Blum: Writing – review & editing.

R. Richter: theoretical background, Methodology, Supervision, Writing – review & editing.

All authors have read and agreed to the published version of the manuscript.

Ethical statement

This study received ethical approval from the local ethic committee of Furtwangen University. The study complies with the Declaration of Helsinki.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.