Family–clinician interactions in children's health services: a secondary analysis of occupational therapists' practice descriptions

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Effective family–clinician interactions are important for good health outcomes. Two types of interactions are consistently recommended: relational (e.g. listening, empathy, and respect) and participatory (e.g. shared decision-making, planning and problem-solving), but there is little specific guidance on how to implement these interactions in practice.


To identify specific, practice-based examples of relational and participatory family–clinician interactions in children's occupational therapy.


A qualitative secondary analysis was used. The data consisted of a list of occupational therapists' self-reported practice actions (n = 217) and direct quotes describing their content and context. The practice actions were categorized into a range of relational and participatory family-centred interactions using a modified framework analysis.


Of the 217 practice actions, the majority [121 (55.76%)] did not describe examples of therapists implementing family–clinician interactions. Of the remaining practice actions, 19 (8.76%) described ‘relational’ interactions (e.g. ‘Listen to carer’, ‘Gather perspectives from others’); 47 (21.66%) described ‘participatory’ interactions (e.g. ‘Identify the family's goals and priorities’, ‘Allow the family to choose’); 2 (0.92%) described both (‘Take guidance from carers’); and 28 (12.9%) were excluded from the analysis.

Discussion and conclusions

A range of relational and participatory interactions were identified. Descriptions of participatory interactions were more frequent than descriptions of relational interactions, and overall the therapists described their family–clinician interactions less frequently than their other practice actions. The specific, real-life examples of different types of interactions identified in the study can be used as a basis for reflection on practice and developing more specific guidance.

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