The therapeutic relationship in telephone-delivered support for people undertaking rehabilitation: a mixed-methods interaction analysis

Abstract

Purpose: The aim of this study was to identify communication features that may affect the
development of the therapeutic relationship during telephone support sessions for people
undertaking self-directed therapy.

Methods: Recorded telephone support sessions of 61 people
with chronic dizziness were analysed for communication behaviour using the Roter Interaction
Analysis System (RIAS). Working alliance was assessed and was correlated with the RIAS to
determine whether communication behaviour affected the therapeutic relationship. Thematic
qualitative analysis of support sessions was then carried out to explore the content of sessions
with high or low levels of person-centredness.

Results: The level of person-centredness was
related to the therapeutic relationship. High person-centred sessions were more likely to
address concerns and include therapist reassurances about the safety of the treatment and its
side effects.

Conclusion: It is possible for rehabilitation therapists to build a strong therapeutic
relationship very quickly and over the telephone. Person-centred communication is important
for the development of the therapeutic relationship during telephone-delivered support.
This research suggests how person-centred communicative behaviours, such as reassurance,
encouragement and approval could be incorporated into practice

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Identifiers

ORCID for Ingrid Muller: orcid.org/0000-0001-9341-6133

ORCID for Sarah Kirby: orcid.org/0000-0003-1759-1356

ORCID for Lucy Yardley: orcid.org/0000-0002-3853-883X

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