Narrative Exploration of Therapeutic Relationships in Recreation Therapy Through a Self-Reflective Case Review Process

Abstract

This narrative inquiry explores therapeutic relationships in the practice of recreation therapy. Narratives were generated in Recreation Therapy’s self-reflective case review process at Sunnybrook Health Sciences Centre—a process developed to support team engagement in reflections on their therapeutic relationships. In total, three self-reflective case reviews were explored, and for each case review, four layers of analysis occurred. The first two layers used narrative analysis to restory reflections of the case review leader (layer one) and then reflections within the recreation therapy team (layer two). The third and fourth layers used analysis of narrative to explore theoretical ideas from person-centred care emerging inductively in the text (layer three), and then to restory the previous narratives using a relational theory lens (layer four). Exploration revealed the self-reflective case review process also strengthens therapeutic relationships within the recreation therapy team. In the recreation therapists’ narratives we hear relational notions of connection, disconnection, reconnection, mutuality, mutual empathy, authenticity, vulnerability, and support. This study engaged recreation therapists in an act of critical pedagogy as they engaged in critical self-reflection by exploring across layers of narrative that story their therapeutic relationships. The self-reflective case review process creates opportunity for the recreation therapy team to recognize, identify and name their experiences within therapeutic relationships, and to find their voices in the medical context of a hospital setting. When engaging in self-reflective processes, recreation therapy moves further away from treating individuals as objects, shifting practice toward connection and mutuality in therapeutic relationships.