Peplau and Therapeutic Relationships

Hildegard Peplau’s theory of therapeutic relationships is foundational to nursing psychotherapy. Historically, Dr. Peplau has been considered the mother of modern psychiatric-mental health nursing. A key part of the theory is the phases of the developing relationship: Orientation, Working (subdivided into Identification and Exploitation), and Resolution. Forchuk and colleagues later expanded on the phases to also consider phases of the non-therapeutic relationship: Orientation, Grappling and Struggling, and Mutual withdrawal. Other key concepts of the theory include communication (verbal, non-verbal, and empathic linkages) and pattern integration (i.e. how the pattern of the nurse interfaces with the pattern of the client). Common examples of patterns include complementary, mutual, and antagonistic. Antagonistic patterns are used to promote change. Peplau’s theory has been supported by research evidence and has influenced other nurse theorists.