Exploring Therapeutic Relationships in Pediatric Occupational Therapy: A Meta-Ethnography.
Sandrine Gagné-Trudel, Pierre-Yves Therriault, Noémi Cantin
PMID 37401246WHAT IT FOUND
Children said the relationship means being heard, but some were told what to do.
Caregivers said trust is the foundation. Therapists said they struggle to balance professional duty with the family. Power dynamics, jargon, and cultural mismatch shaped the experience.
Key findings
01Children described the relationship as meaning their voice is heard, caregivers described it as evolving through trust, and occupational therapists described it as balancing professional responsibility with the family.
02Power dynamics, mutual and clear communication, and collaboration with respect for diversity were the three components that most shaped the experience of the relationship across all three groups.
03All three groups reported that the relationship itself, not just the therapeutic activity, drove meaningful change in their lives.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Nine of the 14 included studies reported the occupational therapist perspective; children (3 studies) and caregivers (5 studies) were underrepresented, so the synthesis leans toward the therapist's view. Three of the 14 studies were rated as methodologically flawed. Removing them did not change most themes, but the 'children's experiences: be heard' theme was affected. Only the first author conducted the synthesis. The author is an occupational therapist, and the paper acknowledges this may have shaped interpretation. The included studies came from public healthcare and school-based settings, with limited sociodemographic data on caregivers and children, so the findings may not generalise to other service contexts.
Declared interests
The authors declared no financial support and no conflicts of interest.
The easy way to misread this
Do not read the 'relationship empowers change' theme as evidence that the therapeutic relationship is the active ingredient producing measurable treatment outcomes. The 14 included studies report subjective experiences and perceptions of children, caregivers, and therapists. They do not measure whether a better relationship leads to better functional, motor, or cognitive scores. Three of the 14 studies were rated as methodologically flawed, and the synthesis was conducted by a single author who is an occupational therapist.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →