Therapeutic Alliance and Its Potential Application to Physical Activity Interventions for Older Adults: A Narrative Review.

Andrew Powell

doi:10.1123/japa.2021-0379

Abstract

Increasing the physical activity (PA) levels of inactive older adults to promote healthy aging and to reduce preventable health conditions is a public health priority. However, there remains uncertainty on what constitutes the most important components and characteristics of effective PA interventions for older adults, and previous research has largely focused on the cognitive and behavioral strategies they adopt to increase uptake and adherence to PA. This narrative review puts forward the novel idea, with supporting evidence, that the strength, quality, and collaborative nature of the professional-client relationship, a concept drawn from the field of psychotherapy and known as therapeutic alliance, may be a vital and foundational element of effective PA interventions. This article will offer a new understanding, and a new direction of research to aid the future conceptualization, design, and development of interventions that aim to increase the PA levels of older adults.

Highlights

Behaviour change; Common factors; Intervention design; Exercise. The purpose of this narrative review is to highlight the potential relevance of therapeutic alliance as a concept to aid the conceptualisation, design and development of effective interventions that aim to increase the physical activity (PA) levels of older adults
Long established as a key element of successful psychotherapy treatments, a rationale and evidence have been presented here to suggest that: 1) therapeutic alliance could be highly relevant for interventions that aim to increase older adults’ PA levels, and, 2) the previous overlooking of therapeutic alliance in PA intervention research could help to explain why there still exists a general lack of foundational understanding on what constitutes their most effective components and characteristics, and why common sense PA interventions are often adopted in the real world
The hope is that the information and arguments put forward in this article will serve as a catalyst for a novel wave of original quantitative research that looks at the influence of therapeutic alliance on the PA behaviour of older adults, and on the outcomes of PA interventions

Summary

Introduction

Introduction The purpose of this narrative review is to highlight the potential relevance of therapeutic alliance as a concept to aid the conceptualisation, design and development of effective interventions that aim to increase the physical activity (PA) levels of older adults. Therapeutic alliance has been established as a foundational element of effective treatments in the field of psychotherapy, and at its heart proposes that a positive and collaborative relationship between client and professional is essential for optimal outcomes regardless of the behaviour or symptom being targeted (Fife et al, 2014).

Results

Conclusion