The Ties That Bind
Forming the patient-therapist bond
By Haley K. Jestice
02.04.08

Forming bonds with patients is important in order for them to want to continue with their therapy.  Maintaining lines of communication greatly impacts the speed of this process. Learn how to connect with patients, while also ensuring the relationship remains strictly professional.

Since therapy is more than numbers, models, plans or facts on paper – and even more than what is logical or factual – it is no surprise that multiple factors determine a patient's success in therapy. One leading influence on patient rehabilitation is the therapist's ability to connect with patients – on their level.

Developing People Skills

“Patients need to feel the sincerity of their therapists,” says Paul F. Davis, an Orlando, Fla.-based international speaker, relational expert and counselor. When people sense that you care, they are more inclined to open up, and listen to what you have to say.

As a former fitness trainer and author of several books, Davis is obviously a man of many talents, and a man with “people” knowledge and insight. He has collected years of education and training, multiple degrees and instruction from Cambridge, Mass.-based Harvard Business School, Hong Kong Law School, the Coaching & NLP Institute of California, and more. However, Davis says, when it comes to bonding with people, book knowledge is secondary.

“No therapy [session] can be successful by merely applying mental models,” says Davis.

So, what is the essential element needed to form a bond with patients? According to Davis, establishing a general interest for the person can help people let down their guard.

“Therapists can bond with patients simply by knowing and calling the patient by their name, and saying the patient's name often,” says Davis. “Be warm and smile when seeing the patient” – identify them.

People who are new to therapy are sometimes skeptical. Sharpen your intuition. Davis says that as part of his training from Long Beach, Calif.-based Reid & Associates (the creator of the polygraph test), he has learned the skill of reading people's body language, which is part of connecting with people.

Some people won't open up immediately, but that's understandable. It's a building process. He says, “Therapists should read body language and the response of patients [in order] to gauge proper interaction, proximity and closeness.”

For example, says Davis, “Therapists can build closeness by extending a handshake, a pat on the back, or – where appropriate – a hug.” However, some therapists of particular modalities may not agree or comply with incorporating a physical aspect, such as the occasional hug that Davis suggests, especially in regard to the age or sex of patients.

Davis does say that for legal reasons, and the comfort of patients, health professionals should be careful of excessive touching or closeness. In general, though, establishing some sense of care and mutual understanding may help when trying to connect with patients undergoing therapy.

Finding Common Ground

Davis says, “A heartfelt connection translates into a deeper bond and an increased ability to build together.” Because, ultimately, after a foundation of trust is established between the two people working toward a similar therapeutic goal, patient outcomes improve.

Additionally, “developing rapport with patients is important,” says Dee Sandquist, MS, RD, director of nutrition, diabetes, weight management and wound healing at Southwest Washington Medical Center in Vancouver.

She adds, developing a mutual liking, trust and sense of understanding will help patients realize the importance of a therapist's involvement in their wellbeing, and that they “sincerely care about them and their situation.”

Essentially, patients are critics. Can they trust that you have their best interests at heart, and that they aren't just another name penciled in for an appointment? Of course they can, but it will take some effort and, perhaps, time.

And, if they don't feel comfortable with you, then they may just look elsewhere for assistance. Someone who may better understand them or show them signs of genuine interest in regard to their health.

A Game of Give and Take

Generally, when people speak “to” someone and not “with” them, the person listening may feel offended or think: “What about me? – Why should I listen to you, when you don't even care to hear what I have to say?” So, a more therapeutic response is to speak “with” someone, not at them.

For the beginner, a simple way to approach a patient is to initiate dialogue. Sandquist says that asking questions or having casual conversations with your patients helps.

She says, “Ask them: ‘Why are you here today?' The answer to this question reveals a lot about their motivation (or lack thereof).” Also, a good way to get to know patients is to question them about their personal experiences. “What prevents you from ____?” Once they begin to open up, Sandquist says you can then help or guide them in developing realistic strategies.

Davis also says that actively listening to patients' words/actions, and asking them questions to clarify your comprehension will increase your perception of the patient's condition. He adds that repeating information back to patients may lend confirmation and assurance that you really do understand their position.

Therefore, careful observation and assessment of different relationship dynamics can help therapists modify or alter the course of action per the individual.

Patients of Every Variety

Therapists should always remember the condition of the patient, says Sandquist. “Adjust the information for age, readiness to learn, mental ability, language, ability to read, write, etc.”

When bonding with patients of various ages – children, teens and adults – should your approach vary? Yes, according to Sandquist. For instance, she says,  “[Registered dietitians] will personalize nutrition for [a patient's] specific medical condition, social setting, age, and/or [other] barriers,” which may influence the success of patients. She says, “We translate the confusing science into reality for specific individuals [and their] conditions.”

Modifying efforts can sometimes improve treatment plans for patients. In addition, patients will know that their therapist cares about them and will help to optimize their health.

What are some ways to adjust or bond to the variety of patient needs, for instance, when dealing with children? Davis says therapists should be sensitive to the physical needs of children, such as honoring the space and location between you.

A way to do this may be to kneel, he says: “to be eye-to-eye rather than looking down.” Another option, says Davis, is to have children sit high up or adjust the therapist seat. This builds an equality and relational intimacy [needed] for bonding with them."


— Haley K. Jestice is a staff writer for T herapy Times. All questions and comments can be directed to hjestice@therapytimes.com .