Clinicians will gain an understanding of what therapeutic alliance is and why it matters—on an individual patient level, on a community level, and for our entire profession. Therapeutic alliance has the power to improve nearly every meaningful outcome for patients.

In order to be ready to deliver service to patients in a way that creates therapeutic alliance, we must understand how to present ourselves. In this chapter, the four components of the therapeutic relationship are discussed, and examples are presented of how we achieve them and where we may fall short.

Expectations are incredibly powerful in determining how an experience is perceived. In order to deliver an experience our patients value, we must understand the expectations they have when entering our care.

To fully understand the impact of therapeutic alliance, we must understand how it is developed throughout the course of care. When we understand the points at which we have mutual trust with our patients, we can then go about challenging unhealthy beliefs and habits and helping our patients build better ones.

We set the tone for the course of care during our very first interaction with the patient. The verbal and physical cues we use either allow us to start to develop trust or create a difficult barrier to overcome during the rest of the session.

Physical therapists spend a lot of time in training developing the ability to generate a treatment diagnosis with our patients. However, we spend very little time learning how to effectively communicate information to our patients. The latter skill is incredibly important, and patients often expect significantly more from our communication than they receive.

There are many treatment options physical therapists can utilize that have similar effects. Learning how to elicit specific patient expectations and preferences is a valuable skill that can help improve patient outcomes.

The end of the initial evaluation is one of the most memorable aspects of care for our patients, and how we perform in that portion of the session can determine how effective our care will be and how likely our patients are to drop off. The “30-second close” is an effective strategy for communicating effectively with your patients and ensuring that they’ve had a positive experience.

In a perfect healthcare environment, we would always be able to have one provider working with the same patient throughout the entire course of care. However, that’s not always reality. Knowing how to communicate, not only within a team of providers but also as a member of each patient’s team, will be important to the success you achieve in building relationships and improving therapeutic alliance.

The ability to develop therapeutic alliance with our patients may be the most valuable skill a clinician can have. Therefore, it is imperative that we not only measure how effective we are at developing therapeutic alliance but also make it part of our discussions that we have in mentoring and training.

Patient engagement is a broad term and includes dynamic and relational concepts. The benefits of improving engagement are far-reaching and significant. Therefore, it is important that therapists understand the impact of this material on their patients and start to develop a framework to assess where patients are in their engagement journeys.

Every phase of engagement brings unique opportunities and challenges for our patients. When in the dependence phase, our patients are frequently scared and overwhelmed and, as a result, may not be compliant. It’s important that therapists modify treatment and communication strategies in order to meet patients where they are mentally and emotionally in this stage and help lead patients to higher levels of confidence and independence.

In the empowerment phase of engagement, patients are becoming more positive and confident. Arriving at this stage allows therapists the opportunity to bring patients into more of an active role in their care and help them become more engaged in their health.

Patients in the self-determination phase are the most independent, which brings unique challenges and opportunities. It’s important that we ask patients questions that help them assess what they want from their health and prepare them for what’s next when they have completed their course of care. In addition, communicating well with our patients in this phase will be valuable in creating a community of healthier, more engaged individuals.

As we add members to the patient’s healthcare team, the high-level communication becomes even more valuable. Therapists need to consider the role of the patient and the family environment in order to maximize the patient's ability to make behavioral change. We also need to communicate information about patient engagement within our own team so that we know not only what to do with a patient, but the context in which we need to deliver those services as well.

We explore the options available for providing digital care and highlight the expectations patients have for rehab therapists.

This chapter provides practical strategies to understand and communicate with patients about digital care.

Learn and implement key words at key times to enhance the patient experience while using digital care.

This chapter provides tips for therapists to overcome the inertia of current patterns of practice that don’t utilize digital care and methods of measuring the impact of making these changes.

Navigate the changing landscape of patient perspectives in the digital era while fostering stronger therapeutic connections and greater patient satisfaction.

Communicate the advantages of digital care effectively, encouraging patient confidence and active participation in the therapeutic journey.

Collaboratively establish clear goals through digital platforms to enhance patient engagement and satisfaction.

Leverage digital tools to nurture rapport, maintain engagement, and ensure mutual accountability while boosting patient contentment.

Solidify trust and continuity in virtual interactions after the initial meeting to strengthen therapeutic alliances and patient happiness.

Navigate complex discussions with innovative digital approaches, fostering patient trust and reinforcing the therapeutic relationship.

Skillfully manage digital communication following challenging sessions, providing ongoing support and empathy for heightened patient satisfaction.