Toward a physical therapy specific model of therapeutic alliance: a historical perspective

Abstract Background Person-centered care is prioritized across health professions as a means to improve health outcomes and patient experiences. Exploring how the role of the patient, and the value placed upon them by health professions, has evolved within a historical context of scientific advancements and misuses provides an increased depth of understanding of how medical and allied health professions have come to prioritize patient-centered care. Objectives To provide a brief history of person centered care in medical and allied health professions; exploring the origins of therapeutic alliance and how it applies to physical therapy practice. Major Findings Therapeutic alliance (TA) has been identified as a central component of person-centered care in psychotherapy. In recent years, the construct has been applied to physical therapy (PT) practice, exploring the impact of TA on patient outcomes. Within physical therapy literature, there have been inconsistencies regarding how TA is operationally defined and what practices contribute to it. Conclusion Returning to the initial evolution of the construct in psychotherapy makes it easier to distinguish which elements are applicable to PT. With this understanding, steps can be made toward codifying a PT-specific understanding of TA that accounts for the profession’s unique approach to care.