Exploring Therapeutic Relationships In Recreation Therapy at Sunnybrook Health Sciences Centre

Abstract

Therapeutic relationships were explored using participatory action research in recreation therapy at Sunnybrook Health Sciences Centre (SHSC). The 22 recreation therapists at SHSC comprised the research team and were actively involved throughout the research process; they determined the research questions, the research process, and engaged in data collection and data analysis. This study explored how recreation therapists understood their therapeutic relationships, how different waves of influences were negotiated and philosophies of care that emerged in their therapeutic relationships. At first glance, therapeutic relationships were understood as meaningful connections and shared experiences that developed over time between a recreation therapist and individual receiving care. Later on, therapeutic relationships emerged as a complex process with welcoming, continuing and closing phases. Positive therapeutic relationships were defined by qualities such as caring, trust, respect, and non-judgment for everyone involved. Therapeutic relationships were also influenced by the organizational context, unit specific cultures, family, and staff members and recreation therapists continually negotiated the expectations, power and boundaries of these influences within their therapeutic relationships. The recreation therapists also discussed the different roles, they and the individuals receiving care could engage in during their therapeutic relationships ranging from the traditional, contemporary or controversial. Findings revealed that recreation therapists’ practices were predominantly influenced by person-centered care philosophies, although the biomedical model and relationship-centred care philosophies were also apparent. The practice of being in the moment emerged as a means of enhancing therapeutic relationships, whereas self-reflective practice assisted the recreation therapists to negotiate different waves of influence on their therapeutic relationships.