The Voice Centered Relational Approach is a qualitative methodology which focuses on the voices (the stories and perspectives) within participant narratives. The theoretical framework underpinning this methodology is commonly considered implicit, with little discussion of how it is enacted within the research process. A core analytic tool in the Voice Centered Relational Approach is the Listening Guide. This has predominantly been used with interview data. Using a longitudinal observational study of engagement practices in stroke rehabilitation, we demonstrate how a theoretical framework can be enacted within the research process, from entering the field to dissemination. We detail how we adapted the Listening Guide for use with multiple forms and sources of data. This provides a guide for researchers who wish to use this approach in the future. We propose that the underlying relational ontology and relational orientation of this methodology makes it a useful approach in researching relational practice in healthcare.