"The Difference Between Being Looked at and Being Seen": an In-depth Consideration of Experiencing the Whole Person Theraputic Approach for Chronic Illness
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The Whole Person Therapeutic Approach (WPTA) is a non-dualistic, person-centred clinical approach to healthcare. Clinicians who operate from this approach hold a unified ontological assumption that subjective and intrinsically individual “mind” elements, such as psychological factors and lived experiences, are all relevant and potentially important factors in the progression of physical disease from onset to recovery. When treating, WPTA clinicians explicitly attend to the whole person including their unique life story as potentially important in treating the presenting symptoms. Using Interpretive Description methodology (ID), this doctoral research provides an in-depth consideration of how interpreting the experiences of persons who suffer from chronic conditions, and who were treated by WPTA clinicians, could inform the care for chronic conditions more generally. A two-phase study was carried out. In phase one, secondary analysis of four segments of video interviews and seven transcripts of interviews were analysed. In phase two, semi-structured interviews were carried out with 18 people seen by WPTA clinicians in mainstream healthcare settings. A purposeful sampling approach was used to recruit 10 participants from an immunology day clinic at a large tertiary hospital, and eight participants from two physiotherapy clinics. Four themes were constructed from the data. Theme one, seeing patients as persons and explicitly acknowledging their unique illness history, captures the importance of feeling acknowledged for one’s personhood. Theme two, clinicians bringing relevant aspects of their whole selves into the therapeutic encounter, captured how participants experienced the subtle negotiation of professional identities, clinical expertise and boundaries undertaken by clinicians within the therapeutic encounter. Theme three, negotiating first encounters, focused on participants’ need to feel listened to and truly heard, before they engage in the WPTA process and to allow WPTA clinicians to gain access to their whole. The last theme, a door into understanding, attempted to capture the essence of what the WPTA experience meant for the participants. This research captured the essence of participants’ experience of “being seen rather than being looked at”, which appeared to be a critical component of care. At its core, it is experienced as being acknowledged for one’s personhood within a therapeutic encounter. Through explicating the subtle and profound ways clinicians achieved this, this research makes significant contributions to knowledge with respect to the ways clinicians can co-construct patients’ readiness to enter into any type of therapeutic relationships. Further, this research is the first to identify the profoundly humanising and transformative educational experience of WPTA from the perspective of the person being treated. This has implications for clinical practice, and clinicians’ education. The findings of this doctoral research can serve as a base for shifting research focus from the individual patient as the sole active agent in their experience of chronic illness to exploring the role relationships with care providers play in this adaptation and therapeutic outcomes. This research also demonstrates the insights that can be gained through attending to the impact of clinicians’ implicit ontological assumptions about the nature of health and illness, on the care experience of patients.