Sufficient Conditions of Therapeutic Personality †Free Samples

Question: Discuss about the Sufficient Conditions of Therapeutic Personality. Answer: Introduction Therapeutic relationship refers to perceived relationship and care that works towards improvement of the quality of healthcare of patient. Therapeutic relationship is known to contribute to patient care and has a direct impact on patient's clinical outcome. There are many different theories that explore therapeutic relationship and elucidate some examples of therapeutic relationship. Therapeutic engagement employs a teamwork approach to patient care and also contributes to patients clinical outcome. Therapeutic engagement has both positive and negative impact on health as therapeutic engagement improves the quality of healthcare (Melanie et al. 2014). In addition, therapeutic relation has both positive and negative impact on healthcare. I think therapeutic relationship is not working well for a number of reasons that need to be addressed for the therapeutic relationship to work in most healthcare facilities (Northway 2017). One of the reasons why therapeutic relationship is not worki ng include busy schedule among therapists and the strategy is argued to be more involving (Sjgren et al. 2017). There are many aspects of care that are a barrier to effective therapeutic relationship with the healthcare setting. One example of this is breakdown in communication that has greatly affected the implementation of the strategy. There are many factors that enhance therapeutic relationship and therapeutic engagement during patient care. The aim of this paper is to explore various aspects of the therapeutic relationship and therapeutic engagement. Therapeutic relationship can be defined in the broad perspective as the positive relationship between professional practitioners and client as perceived by clients. According to Mottram (2009), the therapeutic relationship is clients emotional perception of care relationship that exists between clients and therapist that is connected through positive care, support and perceived safety from life-threatening situations. This implies that therapeutic relationship is developed through high-quality care and respect for a client that is moderated by the professional code of conduct and standards of practice. Nursing practitioners are the forefront caregivers that have to prioritize the therapeutic relationship with clients. Therapeutic relationship has some core pillars that works towards the establishment of this relationship within the healthcare setting. Firstly, clients expectation of the service is vital for establishing a positive therapeutic relationship with patients. Secondly, emo tional support that drives the healthcare practitioner to provide care to a patient is another core pillar that makes a therapeutic relationship works. Thirdly, compassion and empathy are other two pillars of the therapeutic relationship that bear the element of emotional feelings of the patients situation and the need to care for those patients suffering (Margreet 2014). The general meaning of therapeutic engagement may refer to engagement of therapist into giving vital care to clients. For instance, providing treatment to a patient with dementia who require highly specialized complex treatment especially the multidisciplinary care. In addition, staff engagement during complex care help ensure that those life-threatening situations are handled with the care needed of healthcare practitioners. (Richardson et al. 2015) Theories of the therapeutic relationship There are different types of theories that have been advanced to explain the therapeutic relationship. Firstly, Rogers (1951 - 1957) Patient-centered Theory brings therapeutic relationship higher by focusing on intensive care (Faris Ooijen 2012). This theory brings to understanding the importance of various conditions that help uphold patients personality. Person-centred utilizes the relationship rather than care and this is based on developing patient-nurse care. The empathy and well-being among nurses gives the importance of empathy and well-being among nurses especially in case of emergency cases. The relationship between empathy and well-being has been established to explain the characteristic of nursing practitioners when giving emergency care (Bourgault et al. 2015). Secondly, another theory that explains the therapeutic relationship is the teaching student of compassion and empathy (Sandra et al. 2013). This theory based its argument the need to develop good educational materials that enable students to understand the role of empathy and compassion in caring for patients. In addition, teaching students help them develop attitude and skills towards patients and hence offer the best care. According to Richardson et al. (2015), compassion, kindness, and empathy are a good quality of nursing practice and play a critical role in the therapeutic relationship. This theory was advanced by nurse trainers who are advocating for nurse education on the importance of empathy and compassion on the therapeutic relationship. Thirdly, another theory of therapeutic relationship includes multidisciplinary palliative care that involves life-threatening illness. The theory is based on the giving hospice care to dying patients and their families a quality healthcare. The core foundation of palliative care is based on the development of the relationship between the patient, their family, and healthcare practitioners. Moreover, under palliative care applies therapeutic relationship to powerful relationship with patients. This therapeutic relationship creates empathetic communication and hospice care for patients and their families. The interdisciplinary nature of the palliative care makes it a good theory to explain the therapeutic relationship in the sense of relationship and quality care that is an essential expectation of each patient under healthcare (Raffaella et al. 2014). Theory of interpersonal relationship is another theory that exploits the relationship between the nursing practices. As proposed by Hildegard Peplau the theory of interpersonal relationship focuses on the relationship between nursing practitioner and patient. With the theory of interpersonal relationship inter-subjectivity is emphasize than pure rationality. This theory encourages nursing students and practicing nurses to use their nurse-patient interpersonal relationship for discussion aiming to better healthcare service provision (DAntonio et al. 2014). Interpersonal relationship focuses on building an emotional connection between healthcare practitioners and patients. The theory of interpersonal relationship assists nursing practitioners to focus on outcome and not process. Strongs (1968) Social Influence Theory is another theory that attempts to explains the impression created about nursing practitioners and their level of trustworthy. This prevents any resistance that care arise s from handling patient. The theory further suggests the impact of developing social ties with patient (Dorn 1984). The positive impact of therapeutic relationship on healthcare Firstly, therapeutic engagement improves the patients clinical outcome (Antonio et al. 2017). According to Principe et al (2006), some treatments are complex and require high therapeutic involvements of many different therapists composing of multidisciplinary teamwork. For instance, posttraumatic stress disorder (PTSD) requires specialized therapy and many studies suggest that therapeutic engagement play an important role in the treatment of posttraumatic stress disorder (PTSD). Secondly, therapeutic engagement increases attention that is given to the client when offering services to clients (Kornhaber et al. 2016). According to Melanie et al. (2014), therapeutic engagement makes the therapist to be attuned to clients in a manner that show honesty, compassionate, open and personhood. Therapeutic engagement increases the commitment for health practitioners when giving services to their clients with care and honesty. Therapeutic engagement increases the bond between therapist and patients with the goal of meeting clients expectations (Antonio et al. 2017). Palliative care is typical example of care where patients has very strong bond with healthcare givers. Therapeutic engagement enhances the therapeutic environment allowing good interaction between client and practitioner. Therapeutic engagement focuses on enhancing the treatment environment that is conducive to both health practitioner and the patient receiving care. This implies that the environment created under this intensive care allow clients sense of personal choice, independence, and interaction with staff (Principe et al. 2006). A good example of this intervention is person-centered care that focuses on quality of care, quality of life and satisfactory care coupled with organizational culture (Meltzer et al. 2009). There are some negative impacts of therapeutic relationship within the healthcare. Firstly, awkwardness of the therapeutic relationship makes the strategy unpopular among many healthcares. The strategy interference with personal culture and beliefs in one negative impact of therapeutic relationship has on patient care. Developing care relationship between nursing practitioner and patients can sometimes contrast personal beliefs as patients have right to personal beliefs and culture. Therapeutic relationship especially interferes with personal beliefs though this becomes a concern during patient care within life-threatening illness that need close monitor by caregivers. The conflict may result between patient's family and caregivers who seek to offer exhaustive care to the patient (Sjgren et al. 2017). Secondly, therapeutic relationship creates the fear of rejection and unnatural environment making the initiative unpopular among many caregivers. For instance, study by Wanda and Hanson (2002) show the possibility of negative outcome associated by therapeutic relationship in patient. The negative outcome is prospected to result from the initiative contradicting personal beliefs or culture. This implies that therapeutic relationship does not ogre well with some cultures (Kolanowski et al. 2015). The barrier to therapeutic Relationship There are many factors that are a barrier to effective therapeutic relationship with the healthcare setting. Firstly, the breakdown of communication between therapist and patient is an important barrier to the effective therapeutic relationship. Breakdown of communication especially during person-centered care that needs historical information about the client is a barrier to the proper relationship between clients and therapists (Liz et al. 2015). In a study on person-centered care, communication through the word of mouth was proved effective and without this communication, the therapeutic relationship remains a nightmare (Kolanowski et al. 2015). Secondly, personal beliefs and behaviors, especially from the clients side, sometimes become a barrier to the therapeutic relationship since it determines the relationship between therapist and client. Personal beliefs of various people within the healthcare chain play a critical role in giving care and these touches on the relationship building between patient and caregiver. Moreover, community therapeutic service is sometimes difficult given the differences in beliefs and culture (Meltzer et al. 2009). As explained by Antonio et al. (2017), therapeutic relationship can sometimes hang on the courage and emotional support given the complexity of humanized care. Personal beliefs are also accompanied by behaviors that sometimes are not positive to caregivers and reduce the chance for a therapeutic relationship with such individuals. Thirdly, patients documentation and safety concerns are some other factors that are barriers to therapeutic relationship development. Patients documentation and communication of patient's information play an important role in patient safety and person-centered care (Canning et al. 2007). For instance, studies in the UK indicates that there is need to standardize patient's documents to contain vital patients information especially hospital passports documents. This information is used for person-centered care planning. Variation in the information contained in these documents differs causing a barrier to good patient care (Northway 2017). Variations of nursing care from one healthcare to another are a barrier to the therapeutic relationship. Statistics from various hospitals show that there are variations in the quality of care that is given to patients and this is particularly important when establishing a therapeutic relationship that requires intensive care for patients. Unclear understanding of the necessary care given to patients that need care is a good example of differences in care that cause stabling block for the implementation of the therapeutic relationship in a healthcare setting. In addition, variation in nursing care quality needs serious interventions such nursing awareness to restore the required basis of therapeutic relationship (Lucero, et al. 2009). For example, various hospitals has their own policies and this is normally used to plan for care and make care framework different from another healthcare facility. The therapeutic relationship is not working well for a number of reasons that need to be addressed for it to work in most healthcare facilities. Firstly, the breakdown of communication between healthcare practitioners and patient mostly attributed to strict healthcare regulations. Lack of proper communication in person-centered care, for instance, reduces the coordination that is required for multifaceted care that is the basis of therapeutic engagement. Secondly, minimal therapeutic relationship awareness among nursing practitioners makes the strategy to have a low impact on health practitioners. Many nursing practitioners are not aware of the importance of therapeutic relationship and its importance in patient care. Thirdly, some caregivers continuously identify tight and busy schedule as some of the reason they fear adopting therapeutic relationship within the healthcare. This is also due to the augment that therapeutic relationship is more involving when applied to healthcare. Mo reover, few caregivers are aware of the role of therapeutic relationship in person-centered care (Sonya and Nancarrow 2013). For instance, end of life care is often involving many different healthcare practitioners and this is viewed as time consuming among many practitioners. Factors that enhance Therapeutic Relationship/ Engagement There are many factors that enhance therapeutic relationship and engagement during patient care. Firstly, patient and nurse education are one factor that enhances the therapeutic relationship and is important since training create a knowledge base that is important for a therapeutic relationship. Nursing education, especially on therapeutic engagement or therapeutic relationship help, create awareness on the importance of a multidisciplinary approach to patients care that is mostly therapeutic engagement. Patient education deals with personal beliefs that are against the therapeutic relationship. In addition, patient family and cultural beliefs hinder person-centered care and are given to critical patients. Nursing education, on the other hand, assists nursing practitioners to develop compassion, empathy, and care that is needed for patient care (Canning et al. 2007). Secondly, personhood is another factor that enhances the therapeutic relationship and therapeutic engagement. Personhood includes all factors that promote patient care such treating patient with respect, dignity, justice, and truth. Treating the person with respect and dignity is recopies to quality care that facilitates the therapeutic relationship. Personhood help practitioners develop emotional support that is needed for patient care especially those undergoing difficult situations. Personhood is an important factor that forms the basis of counseling and offering emotional counseling to patients with psychological needs and should have counseling. Therefore, personhood should be taught all therapists who hope to offer quality care to patients in healthcare (Sandra et al. 2013). Multidisciplinary and teamwork is an important factor and approach that determines the success of both therapeutic relationship and therapeutic engagement. The ability of many different healthcare practitioners to come together to tackle a serious healthcare problem forms the basic foundation of therapeutic engagement (Faris Ooijen 2012). According to Kornhaber et al. (2016), some specialized care such as palliative care and dementia care requires teamwork or multidisciplinary approach that will give both quality care and expected care. In addition, multidisciplinary approach to the therapeutic relationship has the potential of saving a life, especially when handling with high dignity. This is essential for those aged care facilities where those patients need high dignity and care to live a life full of health (Margreet 2014). Interpersonal relationship is an aspect of patient care that enhances the therapeutic relationship. Firstly, interpersonal relationship increases the positive patient-practitioner relationship that leads to a good patient clinical outcome. Secondly, studies indicate that good interpersonal relationship between patient and caregiver has the capacity to improve the patient experience. Some of the cited outstanding interpersonal relationship skills include listening to the patient, responding to emotional patients emotional needs that are key to patient improvement. Moreover, interpersonal relationship assists patients to open up to their healthcare needs and this important for therapeutic engagement (Principe et al. 2006). Implementation of evidence-based research findings that concerns therapeutic relationship enhances the therapeutic relationship. There are many different studies done on the importance and role of both therapeutic relationship and therapeutic engagement. For instance, there are many research findings on the role of empathy and compassion on the therapeutic relationship. This should be used to train nursing students and nursing practitioners to enhance the application of therapeutic relationship and engagement. In order to make a therapeutic relationship work in most healthcare facilities, all therapists need to be trained on research finding as one aspect of the implementation of these findings (Liz et al. 2015). Conclusion In conclusion, the therapeutic relationship is currently an important aspect of patient care that is well embraced can improve the quality of care. Therapeutic engagement is another essential care strategy with a focus on the multidisciplinary framework. Therapeutic relationship has both positive and negative impact on healthcare. There are some factors that enhance therapeutic relationship/engagement and highly contribute to person-centered care or palliative care since these two cares are important in healthcare. An example of a barrier to therapeutic relationship includes a breakdown of communication. Therapeutic relationship is not working since there are many factors that still make the strategy unpopular among healthcare practitioners. For instance, the central argument is the tight schedule that currently works in healthcare facilities making the strategy more involving. Therapeutic relationship is enhanced by a number of factors that form part of the therapeutic relationship. References Antonio, R., Moreno, P. Delgado, H. Surez-Prez R. Lluch-Canut T., Juan F., Roldn, M. and Montes-Curto P. (2017) Improving the therapeutic relationship in inpatient psychiatric care: Assessment of the therapeutic alliance and empathy after implementing evidence-based practices resulting from participatory action research. Perspective Psychiatric Care, pp19. DOI: 10.1111/ppc.12238 Bourgault, P., Lavoie, S. Paul-Savoie, E., Grgoire M., Michaud, C., Gosselin, E., and Johnston, C.C. (2015) Relationship between Empathy and Well-Being among Emergency Nurses. Journal of Emergency Nursing, vol.41: no.8, pp 323-8. Available at: https://www.ncbi.nlm.nih.gov/m/pubmed/25583425/ Canning, D., Rosenberg, J.P., Yates, P., (2007) Therapeutic relationships in specialist palliative care nursing practice. International Journal Palliative Nursing, vol.13, pp 222229. DAntonio, P., Beeber L., Grayce S. and Naegled M. (2014) The future in the past: Hildegard Peplau and interpersonal relations in nursing. Nursing Inquiry; vol.21, no.4, pp 311317. https://doi: 10.1111/nin.12056 Dorn F.J. (1984) The Social Influence Model: A Social Psychological Approach to Counseling. Journal of development and counseling Vol.62, no.6, Pp 342-345 Faris, A. Ooijen, E. (2012) Integrative counseling and psychotherapy: A relational approach. European journal of psychotherapy and counseling, vol.14, no.34, pp 309-311 Kolanowski A., Kimberly V.H., Janice P., Nikki, H. and Yevchak, A. (2015) Wish we would have known that! Communication Breakdown Impedes Person-Centered Care. The Gerontologist, Vol. 55, No. S1, S50S60. https://doi:10.1093/geront/gnv014 Kornhaber, R., Walsh, K., Duff, J. Kim W. (2016) Enhancing adult therapeutic interpersonal relationships in the acute healthcare setting: an integrative review. Journal of Multidisciplinary Healthcare, vol.9, pp 537546. https://dx.doi.org/10.2147/JMDH.S116957 Liz J., Tara T., MClinPsych B.W., Fenwick J., and Tatjana D. (2015) Negotiating Care in the Special Care Nursery: Parents' and Nurses' Perceptions of NurseParent Communication. Journal of Pediatric Nursing vol.30, p e71e80. https://dx.doi.org/10.1016/j.pedn.2015.03.006 Lucero, R.J., Eileen, T. L. Aiken, L. H. (2009) Variations in nursing care quality across hospitals. Journal of Advanced Nursing, vol.65, no.11, pp 22992310. doi:10.1111/j.1365-2648.2009.05090.x Margreet, C. Lobke B., Mirjam D., Marcella D., Verkaart C. and Cilleke V. (2014) Compassion: The missing link in quality of care. Nurse Education Today, vol.34, pp 1254-1257. Available at: https://dx.doi.org/10.1016/j.nedt.2014.04.003 Melanie, T., Chur-Hansen A. Winefield, H. (2014) The neonatal nurses view of their role in emotional support of parents and its complexities. Journal of Clinical Nursing, vol.23, pp 31563165. Available at: https://wileyonlinelibrary.com/journal/jocn Meltzer L. J., Steinmiller E., Simms, S., and Grossman, M. (2009) Staff engagement during complex pediatric medical care: The role of patient, family, and treatment variables. Patient Education and Counseling vol.74, pp 7783. https://doi:10.1016/j.pec.2008.07.051 Mottram, A. (2009) Therapeutic relationships in day surgery: a grounded theory study. Journal of Clinical Nursing, vol.18, pp 28302837. doi: 10.1111/j.1365-2702.2009.02853.x Northway, R., Rees S. Davies M., Sharon W. (2017) Hospital passports, patient safety and person-centered care: A review of documents currently used for people with intellectual disabilities in the UK. Journal of Clinical Nursing, vol.26, pp 51605168. https://doi10.1111/jocn.14065 Principe, J.M., Cherson, M. DiPuppo J. and Schindewolf, E. (2006) The relationship among patient contemplation, early alliance, and continuation in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, vol.43, pp 238-243. doi: 10.1016/j.jecp.2012.06.006 Richardson, C., Percy, M. Hughes, J. (2015) Nursing therapeutics: Teaching student nurses care, compassion and empathy. Nurse Education Today, vol.35, e1e5. https://dx.doi.org/10.1016/j.nedt.2015.01.016 Raffaella, D., Tenze, M. Palese, A. (2014) An overview of hospice and palliative care nursing models and theories. International Journal of Palliative Nursing, Vol 20, No 2. https://journals.sagepub.com/doi/abs/10.1177/0898010115581936 Rogers, C. (1957) The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, vol.21, no.2, pp 95103. https://app.shoreline.edu/dchris/psych236/Documents/Rogers.pdf Sandra, P. H., Annette, M. L. Marlette, B. R. (2013) Personhood in Nursing Homes: Results of an Ethnographic Study. Indian Journal of Gerontology, Vol. 27, No. 1, pp. 6987 Sjgren, K., Lindkvist M., Per-Olof S., Karin Z. and Edvardsson, D. (2017) Organizational and environmental characteristics of residential aged care units providing highly person-centered care: a cross-sectional study. BMC Nursing vol .16, pp 44. https:// doi10.1186/s12912-017-0240-4 Sonya, B. Nancarrow, S. (2013) Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical Interventions in Aging, vol.8, pp 110. https://dx.doi.org/10.2147/CIA.S38589 Wanda C. M and Hanson I.F. (2002) Negative Aspects of Therapy: Client Perceptions of Therapists' Social Influence, Burnout, and Quality of Care. Journal of Social Issues, Volume55, Issue1 https://doi.org/10.1111/0022-4537.00103