The necessary conditions of engagement for the therapeutic relationship in physiotherapy: an interpretive description study.
Maxi Miciak, Maria Mayan, Cary Brown and 2 others
PMID 29468089WHAT IT FOUND
Therapists and patients identified four conditions needed to build a relationship: being present, receptive, genuine, and committed.
Both parties must actively contribute to these states; the relationship does not happen automatically or through a checklist of skills.
Key findings
01Four foundational conditions were identified as necessary for engagement: Present, Receptive, Genuine, and Committed.
02Patients and therapists must both actively participate in establishing these conditions; it is not solely the therapist's responsibility.
03Being 'present' involves intentional use of time and space, such as staying with a distressed patient or creating a private environment, rather than just being physically available.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Findings are derived from a small sample (18 participants) in private practice settings, which may not apply to hospital or community contexts. The study excluded patients with neurological conditions or those receiving compensation, limiting generalizability to complex or chronic pain populations. Interviews focused largely on the therapist's role, potentially under-representing the patient's specific contributions to establishing conditions. The lead author knew some therapist participants professionally, which could influence data interpretation despite reflexivity measures.
Declared interests
Funded by the Department of Physical Therapy, University of Alberta. No other conflicts declared.
The easy way to misread this
Do not interpret these conditions as a checklist or a guaranteed method for improving clinical outcomes. The study describes what participants valued in the relationship, but does not prove that adhering to these four conditions causes better patient recovery.