Parental perceptions of the parent-therapist relationship: Its impact on outcome

Federal law mandates that early intervention (EI) programs for children from birth to 36 months of age provide care using a family centered model. This study investigated the relationship that develops between physical therapists and parents during EI by examining the outcomes associated with four relationship types. Thirty-nine mothers of children who currently receive, or who had in the past year received, physical therapy through CT\u27s Birth-to-Three program participated in this study. Participants completed six surveys: Parenting Stress Index (PSI), Family Resources Scale (FRS), Measures of Processes of Care (MPOC), satisfaction and control scales and a demographic survey. They also participated in an interview to review their survey responses and their child\u27s progress reports. Scores on the satisfaction and control scales were used to group parents into four relationship types: collaborative (high satisfaction, high control); traditional medical model (high satisfaction, low control); discordant (low satisfaction, high control) and distant (low satisfaction, low control). 44% of mothers were classified as having a collaborative relationship, 20% had a traditional medical relationship, and 18% were placed into the discordant and distant groups, respectively. ANOVA results indicated that mothers in the collaborative group experienced less parenting stress and felt more competent than mothers in the distant group. They were also more likely to describe the relationship with their child\u27s therapist as family centered. Backward multiple regression analyses suggested that family resources and satisfaction with the relationship accounted for a significant amount of the variation seen in parenting stress. A significant amount of the variation in parenting competence was explained by satisfaction with the relationship and perceptions of the therapist\u27s family centered behaviors. Finally, satisfaction with the parent-therapist relationship accounted for a significant amount of the variation in child progress. The findings suggest that the interpersonal aspects of care in EI have a significant impact on parent and child outcomes. They also suggest that satisfaction has a greater impact on the outcomes studied than control. The families\u27 access to resources also impacted significantly on outcome.