Negotiating expectations for therapy between mothers and service providers: a narrative analysis

Abstract

Purpose

To use stories about mothers and service providers negotiating expectations for therapy to illuminate processes contributing to power differences within partnerships.

Methods

This narrative study presented stories from three mothers and three service providers. Stories were co-constructed between participants and researchers and analyzed using narrative analysis. Building on An and Palisano’s (2014) Model of Family-Professional Collaboration, stories were organized into the stages of goal setting, planning, and doing therapy.

Results

Each story illuminated a process unique to that story that can redistribute power between mothers, service providers, and therapy environments while negotiating expectations: protecting sacred issues, facilitating knowledge exposure, filling voids/vacuums, recognizing cultural conditioning, re-discovering eclipsed roles, and connecting relay teams. We propose including three additional strategies to An and Palisano’s model to increase the readiness of mothers and service providers to negotiate expectations for therapy and collaborate fully as the model intends: 1) exploring power-sharing conversations; 2) looking for social context clues; and 3) adopting a humility stance.

Conclusion

Information on the six illuminated processes can help structure a client story grounded in optimal negotiation of expectations and equal partnerships.

Implications for Rehabilitation

• Knowledge of diverse stories about mothers and service providers negotiating expectations for therapy can be a resource to guide actions in related situations.

• Leaving the topic of expectations for therapy implicit or unchallenged increases the risks that negotiations remain unbalanced and unproductive.

• Service providers may enhance collaboration with mothers in paediatric rehabilitation by exploring power-sharing conversations, looking for social context clues, and adopting a humility stance.

Keywords:

• Negotiate
• expectations
• therapy
• paediatric
• narratives
• stories
• power
• humility

Acknowledgements

The research team thanks participating families and service providers. This research was supported by a Joseph-Armand Bombardier Canada Graduate Scholarship and a Kimel Family Graduate Student Scholarship in Paediatric Rehabilitation. Gillian King holds the Canada Research Chair (Tier 1) in Optimal Care for Children with Disabilities, funded by the Canadian Institutes of Health Research. This chair is supported by matching funds from the Kimel Family Opportunities Fund through the Holland Bloorview Kids Rehabilitation Hospital Foundation. This research is dedicated to Jake Bloomfield, Patty Rigby, Virginia Barcarse, and Oliver Smart.

Disclosure statement

The authors report no conflicts of interest.