The therapeutic alliance is the collaborative relationship between the healthcare practitioner and the patient, encompassing a bond between the two, and their agreement regarding the goals of care and the different therapeutic tasks and interventions. Healthcare professionals regard the therapeutic alliance as an integrational aspect of care. Moreover, evidence from clinical research demonstrates that the effectiveness of patient-centered care is highly dependent on a robust therapeutic alliance. Originally developed within the field of psychotherapy, the concept of the therapeutic alliance is becoming central to other healthcare professions where patient care is now primarily underpinned by the biopsychosocial model of care; this includes, for example, practitioners working in the field of musculoskeletal care.
The therapeutic alliance is a cornerstone of proper biopsychosocial evaluation, and its impact upon the treatment merits further investigation. It has recently been proposed that an enactive approach which links embodied experience to action, cognition and emotion, would facilitate such investigation. Enactivism argues that through a dynamic interaction between an acting organism and its environmental constraints, individuals make sense of their internal and external environment. This sense-making requires the individual infer the causes of sensation in their environment, with adaptive response leading to flexible inferential models updated appropriately. An enactive approach is underpinned by the Free Energy Principle and its corollary active-inference theory. The Free Energy Principle explains how dynamic adaptive systems maintain their order, i.e., non-equilibrium steady-state by restricting themselves to a limited number of states and therefore minimize surprise or disequilibrium. Adaptive change made by an organism or biological system, therefore minimizes long-term average surprise. A breakdown in the adaptive capacity of the patient due to an inflexible or distorted updating of inferential models will lead to illness, with the therapeutic alliance available to support healthful adaptation. It is argued that an enactivist approach will better facilitate investigation into causative factors that support health across any treatment discipline.
It is, arguably, critical to investigate markers and mechanisms that enable successful patient-centred care, and the establishment of a robust therapeutic alliance in a range of body-mind healthcare disciplines such as psychotherapy and psychiatry, and musculoskeletal care and pain management in general. This Research Topic will seek to examine and advance knowledge in these areas of clinical practice. We welcome interdisciplinary and multidisciplinary contributions on the role of enactivism, free energy, and active inference in the development of robust therapeutic alliances in psychological, manual therapy, musculoskeletal, pain management and related fields, including those which seek to develop theoretical and neurocomputational models applied to the therapeutic alliance. We welcome the following article types: Original Research (both qualitative and quantitative), Opinion, Review, General Commentary, Case Reports, Hypothesis and Theory.
The therapeutic alliance is the collaborative relationship between the healthcare practitioner and the patient, encompassing a bond between the two, and their agreement regarding the goals of care and the different therapeutic tasks and interventions. Healthcare professionals regard the therapeutic alliance as an integrational aspect of care. Moreover, evidence from clinical research demonstrates that the effectiveness of patient-centered care is highly dependent on a robust therapeutic alliance. Originally developed within the field of psychotherapy, the concept of the therapeutic alliance is becoming central to other healthcare professions where patient care is now primarily underpinned by the biopsychosocial model of care; this includes, for example, practitioners working in the field of musculoskeletal care.
The therapeutic alliance is a cornerstone of proper biopsychosocial evaluation, and its impact upon the treatment merits further investigation. It has recently been proposed that an enactive approach which links embodied experience to action, cognition and emotion, would facilitate such investigation. Enactivism argues that through a dynamic interaction between an acting organism and its environmental constraints, individuals make sense of their internal and external environment. This sense-making requires the individual infer the causes of sensation in their environment, with adaptive response leading to flexible inferential models updated appropriately. An enactive approach is underpinned by the Free Energy Principle and its corollary active-inference theory. The Free Energy Principle explains how dynamic adaptive systems maintain their order, i.e., non-equilibrium steady-state by restricting themselves to a limited number of states and therefore minimize surprise or disequilibrium. Adaptive change made by an organism or biological system, therefore minimizes long-term average surprise. A breakdown in the adaptive capacity of the patient due to an inflexible or distorted updating of inferential models will lead to illness, with the therapeutic alliance available to support healthful adaptation. It is argued that an enactivist approach will better facilitate investigation into causative factors that support health across any treatment discipline.
It is, arguably, critical to investigate markers and mechanisms that enable successful patient-centred care, and the establishment of a robust therapeutic alliance in a range of body-mind healthcare disciplines such as psychotherapy and psychiatry, and musculoskeletal care and pain management in general. This Research Topic will seek to examine and advance knowledge in these areas of clinical practice. We welcome interdisciplinary and multidisciplinary contributions on the role of enactivism, free energy, and active inference in the development of robust therapeutic alliances in psychological, manual therapy, musculoskeletal, pain management and related fields, including those which seek to develop theoretical and neurocomputational models applied to the therapeutic alliance. We welcome the following article types: Original Research (both qualitative and quantitative), Opinion, Review, General Commentary, Case Reports, Hypothesis and Theory.
