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Therapeutic relationships. Evolution of the Children's Hospital of Philadelphia model
1Children's Hospital of Philadelphia, Pennsylvania 19104, USA. mcklindon@email.chop.edu
Insights
This study outlines the development of therapeutic relationships between nursing staff and pediatric patients, emphasizing a caring, clear, and professional approach. It details strategies for fostering these essential connections within family-centered care models.
Area of Science:
- Pediatric Nursing
- Healthcare Relationship Dynamics
- Family-Centered Care
Background:
- Increasing healthcare complexity impacts nurse-patient/family relationships.
- Family-centered care is a growing model in pediatrics.
- The Children's Hospital of Philadelphia (CHOP) recognized the need to define therapeutic relationships.
Purpose of the Study:
- To describe the evolution of therapeutic relationships as a standard of practice.
- To define the parameters for developing and maintaining therapeutic relationships.
- To integrate therapeutic relationships within a family-centered care framework.
Main Methods:
- Articulating principles of therapeutic relationships.
- Providing clinical examples.
- Developing strategies for assessment, management, and evaluation.
Main Results:
- Therapeutic relationships are defined as caring, clear, boundaried, positive, and professional interactions.
- These relationships encompass institutional philosophy and empowerment of caregivers and families.
- The article presents a comprehensive approach to implementing and evaluating therapeutic relationships.
Conclusions:
- Therapeutic relationships are integral to effective family-centered pediatric care.
- Clear parameters and strategies enhance the quality of nurse-child-family interactions.
- This framework supports the empowerment of both healthcare providers and families.
Abstract:
The evolution of family-centered pediatric care coupled with the increasing complexity of healthcare environments has had a tremendous impact on the nature of relationships between nursing staff and the children and families they serve. In order to address this, in 1988 the Nursing Department at the Children's Hospital of Philadelphia (CHOP) identified parameters for the development and maintenance of therapeutic relationships. A therapeutic relationship is an interactive relationship with a child and family that is caring, clear, boundaried, positive, and professional. It encompasses the philosophy of the institution, empowerment of the caregivers, and empowerment for families. Utilizing family-centered care as a framework for the delivery of care, this article describes the evolution of therapeutic relationships as a standard of practice including the articulation of principles, clinical examples, implications for practice, and strategies for assessment, management, and evaluation.