I am Aoi Hashima , an occupational therapist living and working in Fukuoka.
Because of work, I have to talk about various things with patients who have just been hospitalized.
The content of the conversation with the patient will be asked questions such as "physical problems", "anxiety" and "questions you would like to ask about the disease".
The person who has just been hospitalized, has just been transferred to a hospital or has just been hospitalized from home, and this is the first time we met.
To allow first-time rehabilitation staff to speak up, we do our best to create an atmosphere that is easy to talk to and gain their trust.
As recovery progresses, I hope to develop better relationships with patients.
This time, I want to write about the therapeutic relationship between the patient and the rehabilitating person.
The composition of the therapeutic relationship experienced by the client
In reference 1), I will describe from the client's perspective, based on research on the therapeutic relationship between the client and occupational therapist.
Reference 1) describes the formation and meaning of the client's experience in the therapeutic relationship with the occupational therapist as follows.
□ Expectations and anxiety about the therapist
□ Therapeutic touch and emotional interaction
□ Unexpected occupational therapy
□ Realization of signs of improvement
□ Engagement that exceeds expectations
□ Know my existence now
In a lot of hospitals, the staff in charge of recovery are younger than the patients, and I think in many cases people are concerned about whether they can be trusted.
After a stroke, one of these pathological states is the "depressed state".
I've just been hospitalized and worried about whether I can trust the rehab people I met for the first time.
I'm always worried that I'll be tired both physically and mentally because of the various tests I go through during my anxiety.
I think it's important to build trusting relationships with patients early on.
Listen to the experience of the people involved
In reference 2), a workshop is planned to share the experiences of stroke survivors with occupational therapists, and research on how occupational therapists' awareness changes before and after the workshop is reported.
Occupational therapists who usually care for stroke patients attended the workshop, but the following realizations emerged from listening to the experiences of stroke patients.
□ The existence of conjecture
□ Divergent goals
□ Outdoor environment
□ The importance of words and deeds of medical staff
□ Limited time
By listening to their patients' experiences, occupational therapists are able to understand how patients are feeling and how they approach rehabilitation.
In reference 2), workshops were held on "I never thought the hospital was a remote environment for patients" and "Stories of being hurt by negative remarks from medical staff impressed me". The words of the occupational therapist who received it were recorded.
Little opportunity to learn about therapeutics as part of graduate education
When you are a rehabilitation student, you will study psychology and other subjects and will be educated to be a rehabilitation worker who supports the feelings of patients.
However, once you graduate, you may have little opportunity to learn about the therapeutic relationship between patients and rehabilitating staff.
We learn by doing in order to work towards a better relationship with patients in a clinical setting, but there are many learning programs that focus on learning rehabilitation techniques and we study the therapeutic relationship with patients. Personally, I have the impression that there are not many meetings.
If we don't consciously think about the therapeutic relationship with the patient, I think there is very little opportunity to reflect on the attitude of the rehabilitation staff in the usual clinical setting.
From the perspective of the patients I am responsible for, I believe it is necessary to always consider the therapeutic relationship that the patient experiences with the rehabilitating staff.
There is more research on goal setting between patients and rehabs than in the past, so I think rehabs should read the various reports.
I also believe that the best way to learn is to listen to the feelings of the patients I am responsible for.
By studying peer tutoring, I want to improve my listening skills and face daily rehabilitation support.
1) Shimada Ryuichi et al: What is the experience of the therapeutic relationship between the client of the rehabilitation ward and the occupational therapist? Occupational Therapy Vol.40 No.5.2021
2) Takano, Daiki: Sharing the impact of conflicting beliefs experienced by stroke survivors on occupational therapist cognition and behavior. Japanese Clinical Occupational Therapy Study No. 7: 31-38, 2020
☆*:.｡.Thank you for reading till the end.｡.:*☆
This article was reprinted on October 23 , 2022 on Aoi Hashima's blog " Stroke Rehabilitation Longevity Consultation Center " .