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Therapeutic rapport in First Peoples’ health

In the healthcare setting, meaningful relationships are equal to, if not more important than health service outcomes for First Peoples. Let's explore.
A smiling health care practitioner sits to take the blood pressure of her client.
© Griffith University

When it comes to healthcare, did you know Australia’s First Peoples consider the establishment of meaningful relationships to be equal to, if not more important than, service outcomes?

It’s all about building trust and a sense of connection. So, how should you go about that?

Building therapeutic rapport with Australia’s First Peoples follows the same principles as with any other client, family or community. The problem is, many Australians’ beliefs about First Peoples are misinformed by historical stereotypes. These assumptions can dramatically impact on the ability to achieve therapeutic rapport with Aboriginal and Torres Strait Islander clients, families and communities.

Let’s explore the key elements of rapport, based on the work of Carl Rogers.

1. Let go of your judgment

Each of us knows and ‘feels’ when we are being judged. To successfully make connections with anyone you meet, you need to work on identifying your biases and preconceived ideas and actively challenge them. Judgment of any client has no place in your work. All clients need to feel a sense of unconditional positive regard in order for you to build effective working relationships with them. Meet and treat each person in your practice with an open mind and heart.

2. Show empathy

Compassion and understanding goes a long way to building connections with others. Remember, empathy is not sympathy. Empathy requires us to ‘walk in another’s shoes’ and it comes from a position of strength, not weakness. Since colonisation, Australia’s First Peoples have been disadvantaged and marginalised. While these challenges continue today, it is important for non-Indigenous health professionals to provide care that builds on strengths, whilst still being respectful of First Peoples’ history.

3. Be genuine

Humans are wired to spot insincerity and inauthenticity quickly. Like anyone else, when an Aboriginal or Torres Strait Islander senses insincerity, it will be impossible for you to develop trust. Without trust there can be no rapport. Due to colonisation and the distressing political and social events that continue today, First Peoples are particularly sensitive to issues of trust and insincerity with non-Indigenous people.

What happens when rapport is not achieved?

When you fail to establish rapport with any client, poor outcomes will follow.

For example: If the client feels judged or patronised, or senses you’re not being ‘real’ they will tend to shut down. The client will understandably be less forthcoming with the information they share, which will make it harder for you to achieve good outcomes. It may also result in the client losing heart and failing to return for follow up appointments or adhere to the advice you have provided.

Aboriginal people are more interested in who you are rather than what you are. Establish rapport by allowing Aboriginal and Torres Strait Islander clients to get to know and understood you as a person. This helps promote their confidence and trust in you as a practitioner.

Active listening

As with any other client, active listening skills are required when working with Aboriginal and Torres Strait Islander peoples. Are you guilty of selective hearing and one-way conversation? It won’t serve you well with any client. Brush up on your active listening skills to build therapeutic rapport. For example, use paraphrasing techniques to clarify the message you have received, reflect feelings, demonstrate empathy and avoid ‘talking over’ the client.

Sometimes there is a fear of communicating incorrectly or ‘getting it wrong’, which prevents practitioners from behaving naturally. It’s important to relax and be yourself. When meeting an Aboriginal or Torres Strait Islander for the first time, the same rules of relationship building apply.

For example:

  • always introduce yourself
  • have confidence in sharing appropriate information about yourself
  • ask where people are from
  • find topics of shared interest

Your task

How do you go about building rapport and making connections with others? Share your ideas and stories with the group using the comments link below.

© Griffith University
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Safer Healthcare for Australia's First Peoples

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