Morrison Tricia L, Smith J David
Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Aust Occup Ther J. 2013 Oct;60(5):326-33. doi: 10.1111/1440-1630.12053. Epub 2013 Jun 16.
Despite reverence afforded the therapeutic relationship construct in occupational therapy, many occupational therapists feel ill equipped to use themselves therapeutically to enhance the relationship with their clients. Furthermore, although occupational therapists often link the strength of the therapeutic relationship to therapy outcomes, related occupational therapy specific research has been limited. According to the psychotherapy literature, the working alliance is one element of the therapeutic relationship which has in fact been linked to therapy outcomes.
A mixed-methods, prospective, multiple case study approach was used to compare the experiences of the working alliance by both occupational therapists and clients across four therapeutic dyads.
Several key elements were identified in this study's qualitative data as shaping the process of alliance development in occupational therapy including: the fostering of an interpersonal connection; the use of humour as therapeutic modality; an impetus to act that leads to functional enhancements; a shared sense of success and a positive feedback mechanism created through successfully attaining clearly delineated, client-centred therapy goals.
By considering these identified elements, occupational therapists may focus upon tangible considerations towards enhanced therapeutic use-of-self in the development of sound working alliance with their clients potentially improving therapy outcomes.
尽管职业治疗中重视治疗关系这一概念，但许多职业治疗师觉得自己缺乏以治疗性方式运用自身来加强与客户关系的能力。此外，虽然职业治疗师常常将治疗关系的强度与治疗效果联系起来，但相关的职业治疗特定研究却很有限。根据心理治疗文献，工作联盟是治疗关系的一个要素，实际上它已被证明与治疗效果有关。
采用混合方法、前瞻性、多案例研究方法，比较了四个治疗二元组中职业治疗师和客户对工作联盟的体验。
本研究的定性数据中确定了几个关键要素，这些要素塑造了职业治疗中联盟发展的过程，包括：建立人际关系；将幽默用作治疗方式；促使行动的动力，从而带来功能改善；共同的成功感以及通过成功实现明确界定的、以客户为中心的治疗目标而建立的积极反馈机制。
通过考虑这些已确定的要素，职业治疗师在与客户建立良好工作联盟的过程中，可能会专注于切实可行的考虑因素，以加强治疗性自我运用，从而有可能改善治疗效果。
