The relationship between the patient and the psychologist or psychotherapist is called therapeutic alliance and is considered as an important factor towards the outcome of psychological therapy.

Similarly, with practitioners using musculoskeletal therapies, it’s called patient-therapist interactions. According to a research report published in May 2016 based on a qualitative systematic review and meta-synthesis concluded that a mix of interpersonal, clinical and organisational factors influence patient-therapists’ interactions. Further research is merited to narrow down those specific factors.

As Chinese medicine practitioner, we are very much physical therapists as most would predominantly apply acupuncture as physical therapy. But as Chinese medicine practitioners, we also hear about our patient’s emotions and psychological states, their stresses and challenges in life. We depend on hearing those detail on their mental states as often it will assist us in refining our Chinese medicine diagnosis.

As Chinese medicine practitioners, we need to be highly skilled in communication so we can accommodate for those tricky situations in the treatment room and protect ourselves from being too affected by our patient’s stories.

How important is the therapeutic alliance or the patient-therapist interaction for Chinese medicine practitioners? According to research, the bond or relationship between the practitioner and patient determines the treatment outcome.

As yet, the specific factors are unclear, but we have general idea on what’s important to have the best possible connection, bond or relationship with our patients. The following influences are derived from the research report but also very much reflect the way I practice.

Clear communication skills particularly active listening

Active listening involves the patient being able to tell their story and us practitioners actively listing with all our senses. It means being fully present with the person in the treatment room, letting them know that you have understood and providing the space, respect, confidence and warmth for the conversation to unfold.

Expressing and feeling empathy

‘Empathy is the capacity to understand or feel what another person is experiencing from within their frame of reference, that is, the capacity to place oneself in another’s position.’ Empathy is not feeling sorry for our patients but expressing to our best ability our understanding to how they are feeling. The research did show that a lack of empathy was having a negative impact on the bond between the therapist and the patient.

Being friendly end adopting a sense of humour

A friendly word and a smile go a long way. Everyone knows that. So, let’s do it more often and throw in a little humour, where appropriate and we can conquest people’s hearts. Being friendly and welcoming doesn’t cost anything, and friendliness is often repaid multiple times despite your possible judgment that someone doesn’t deserve it.

Encouragement and confidence

There is nothing like inspiring patients and encourage them to take their health to the next level. Be mindful to accept and respect where they are, rather than where you are. A little bit of encouragement will make your patients confident to keep walking the path to health and balance, one step at the time. Patients like their therapists to be confident practitioners (knowing what they are doing) but be mindful of coming across as overconfident which may be interpreted as arrogance and is counteractive to a positive relationship.

Simple and easy explanations

When it comes to applying practical skills, patients value a simple explanation to what we think their problem is, how we will help them (solving that problem) and why we are recommending treatment methods, herbs, exercise, diet and lifestyle changes. Patients are more likely to be on board if they know what the plan is. It’s also important to discuss treatment goals. Setting goals will bring expectations to a mutual level.

Technical skills and expertise

It’s important for both the practitioner and patient to possess the relevant skills for a treatment method. The expertise enhances the trust of the patient in the practitioner and the modality which helps to develop a strong and positive relationship.

Individual patients require individual treatments

A patient receiving tailored treatment methods and plans is more likely to build trust and strength in their practitioner. The Chinese medicine framework provides a particularly well-suited body of wisdom to accommodate for this need. It’s important to mention to patients that our treatments are fully customised to suit their situation. It’s easy to understand that this will make your patients feel valued and well catered for.

Time is worth so much

We all know how things do take time and to to offer the gift of time are well invested moments not only for our patients but also for ourselves. So, when someone needs more time, there will be someone else who requires less and at the end of the day, it all works out. Give time, so patients can relax and build confidence and strong relationships with you.

Flexibility with appointments and care

It’s important to accommodate for the needs of our patients, and we certainly aim to do the best we can. It’s also great to remain flexible (obviously it must work out for us as well) and give care sometimes when they don’t have appointment and just need some simple advice. This will encourage patients to build trust and confidence.

I aim to optimise all those subtle points with my patients every day. However, I am the first to admit that we do have ups and downs in the clinic and are not always performing at optimal levels. I feel this summary is a good reminder for us to further develop our bedside manners to enhance the therapeutic alliance with our patients and hence impact the outcome of our treatments to our best ability.

Feel free to comment your own experience, insights and feedback.


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