Children’s Experiences of the Therapeutic Relationship in Occupational Therapy: A Phenomenological Study

AIM: The aim of the study was to examine children's lived experiences of the therapeutic relationship with their occupational therapist. METHODS: A hermeneutic phenomenological design was used. Fourteen children aged 2 to 10 were recruited through occupational therapists at various sites within a healthcare institution in Quebec (Canada). Individual art-based interviews were conducted with children. A hermeneutic phenomenological analysis was used to identify themes emerging from their experiences. RESULTS: Children's experiences of the therapeutic relationship reflected four main themes. First, trust-building emerged as central, with children highly attuned to nonverbal cues such as empathic gaze and active listening. Second, children highlighted the importance of feeling genuinely heard and understood in their therapeutic journey. Third, the learning process, with its progress and challenges, was shaped by the therapist's responsiveness. Finally, a shared understanding of therapeutic activities fostered a strong connection, especially when the activities held personal meaning for the children and reflected their own goals. CONCLUSIONS: This study showed that children value being heard, understood, supported, and engaged in meaningful therapy activities that reflect their goals and interests. Their experiences emphasize the importance of recognizing children as active participants and integrating their voices into the co-construction of therapeutic relationships.