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Therapeutic Relationships: Evolution of The Children's Hospital of Philadelphia Model

McKlindon, Donna MSN, RN; Barnsteiner, Jane H. PhD, RN, FAAN

MCN, The American Journal of Maternal/Child Nursing: September-October 1999 - Volume 24 - Issue 5 - p 237-243
Feature Articles

The evolution of family-centered pediatric care coupled with the increasing complexity of healthcare environments has had a tremendous impact on the nature of relationships between nursing staff and the children and families they serve. In order to address this, in 1988 the Nursing Department at the Children's Hospital of Philadelphia (CHOP) identified parameters for the development and maintenance of therapeutic relationships. A therapeutic relationship is an interactive relationship with a child and family that is caring, clear, boundaried, positive, and professional. It encompasses the philosophy of the institution, empowerment of the caregivers, and empowerment for families. Utilizing family-centered care as a framework for the delivery of care, this article describes the evolution of therapeutic relationships as a standard of practice including the articulation of principles, clinical examples, implications for practice, and strategies for assessment, management, and evaluation.

Donna McKlindon is a Clinical Nurse Specialist-Mental Health, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. She can be reached c/o Children's Hospital of Philadelphia, 34th & Civic Center Boulevard, Philadelphia, Pennsylvania 19104; e-mail:

Jane H. Barnsteiner is Director of Nursing Practice and Research, The Children's Hospital of Philadelphia, and Professor of Pediatric Nursing, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania.

© 1999 Lippincott Williams & Wilkins, Inc.