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This chapter focusses on the contribution of health professionals' communication competences to patients. We propose a model of communication to be used in the therapeutic relationship, supported by a literature review. The methodology is qualitative. Four focus groups (FGs) composed of Portuguese health professionals (N = 25), such as medical doctors, nurses and professors in health fields, were conducted during 2017 and 2018. All the participants of FGs validated a three-factor aggregated and interdependent model, which is composed of assertiveness, clear language and positivity (ACP model). The factors reinforce the therapeutic relationship and improve health literacy, thus reinforcing the patient's health and well-being. The argument is that health is wealth, so if the communication can improve health, then this has positive social implications. The study is a response to the lack of consensus in the literature on what specific and operative communication competences the health professional should perform in clinical encounters with the patients, and how these competences can improve, in the final instance, their health and well-being.

In the previous chapter, I introduced the reader to the ideas and research of the common factors. The common factors are varied and have demonstrated to have small to large effect sizes depending on what variable is being examined. In this chapter, I categorise four more evidence based relationship variables which tend to be more task orientated and aligned to the therapeutic alliance. Indeed, the therapeutic alliance, goals and collaboration, alliance rupture–repair, and feedback-informed care are four trans-theoretical factors that can contribute greatly to outcomes. At the same time, when poorly established they can and do impact negatively on client outcomes. This is not an exhaustive overview of the literature, rather each variable is briefly discussed, the evidence supporting the effectiveness is highlighted, and Top Tips are provided to assist the development of the practitioner.

We are currently experiencing, in western societies, a new reality in health systems, the emergence of an epidemic of chronic diseases, which test and raise new challenges to the health systems. This exponential increase in chronic diseases has not been accompanied by updated training of health professionals in this area. The chronic illness implies a bilateral relationship, of commitment and compromise for life, in which the involvement of the sick person must be the rule. The scope of therapeutic education (TE) is making the person autonomous and helping them to maintain or improve their quality of life. To treat patients with chronic disease, health professionals need to adapt their knowledge to their new role in the therapeutic relationship. As for the methodology, a participative observational methodology will be carried out with the training of health professionals who work in this area. It is a descriptive work based on studies and works published by the main schools working in this area, with emphasis on the School of Geneve. The purpose is to identify the problem of chronic diseases, the challenges that patients and health professionals face and how to build educational projects, exploring the use of educational tools, including digital technology.

In an era where health professionals are increasingly demanding, and communicative skills are one of the keys to improve the relationship with the patient. The communicative competencies of assertiveness, clarity in verbal and non-verbal language, and positivity, based on the positive construction of the patient’s health path, improve the therapeutic relationship, as well as the relationship between professionals in the world of health complexity. The ACP Model is validated with extensive application by hundreds of professionals in Portugal who use it daily. Active learning is one of the most effective means of raising awareness and involving the professionals who are learning and implementing the ACP Model.

Though undergoing changes for a decade, the foster care system in Poland is still dominated by the adult model of childhood management. Assuming that the biological, psychological and social immaturity of children precludes their autonomy, this model expects adults to focus on control over the integration of a child into society. A consequence is the instrumentalisation of childhood and the deprivation of a child's sense of agency, i.e., the right to (co-)create one's own life space. Additionally, the foster care system concentration on adult problems relegates children to the background. Treatment of children as the object of adult interactions significantly impedes approaches that could empower, reduces chances for relationships built on dialogue, limits a child's openness and authenticity and hinders development of his/her identity structure and resourcefulness. Such institutionalised systems do not satisfy a child's needs, especially unconditional acceptance, enjoyment of life, and self-fulfilment. Instead, from the child's perspective, residential/foster care is a traumatic experience that deprives a human being of childhood. Such an institutional experience interferes in the acquisition of functional patterns for adulthood, reinforces traumas, and denies a chance to reclaim one's childhood. Research conducted with children indicates a need for a change in direction. The aim herein is to show the current situation of children in the Polish foster care system, identify threats to the development of an autonomous identity, and present an alternative, child-centred foster care model in which the caregiver treats the child as a competent person.

Research has shown that Indigenous people suffer significant health inequalities in comparison to dominant colonising cultures. Evidence shows that these inequalities can be addressed by gaining a deeper understanding of the social and cultural determinants of health, applying Indigenous views of health and developing better definitions of the term wellbeing. The following chapter draws on research exploring the relationship between Indigenous culture, the landscape and the connection with health and wellbeing. In Aotearoa/New Zealand, consideration of Indigenous Māori is a national imperative, enshrined in the Te Tiriti o Waitangi (Treaty of Waitangi) which establishes it as a bicultural country. Exploring three Māori health models, the chapter examines the factors that play a significant role in shaping Māori people's health. It relates how landscape is a foundational therapeutic aspect of Māori wellbeing using the models to express the forces that impact both positively and negatively on this relationship. The chapter concludes that all three concepts, culture, health and landscape, are interconnected and must be balanced to reduce Māori health inequalities and to provide a more sustainable model for health and wellbeing for all New Zealanders.

Based on ethnographic data and a textual analysis, this chapter highlights the process of “therapization” of Buddhism in Western countries, with a specific emphasis on Tibetan Buddhism in France. Referring to the paradigm of “political economy of health”, as developed in recent medical anthropology, it attempts to explore the relationships between two concepts – economics and health – that had previously been considered separately, in the context of Western Buddhism. Further, this chapter's aim is to expose a potential application of theoretical economic models in an anthropological approach of Buddhist diffusion and appropriation in the West.

Border crossing between systemic and racial identity theories can contribute to systemic research on Black therapists work with White families.

Questionnaires were used to gather data from 29 Black, Asian and Mixed Heritage therapists in order to test the significance of variables associated with transgenerational advice, socialisation experience, professional training and therapists’ perception of successful outcomes (n=29). The study concluded that White clients were associated with the contact and disintegration statuses at the beginning of therapy, and that Black therapists were associated with being at least two racial identity statuses in advance of their White clients. In addition, results showed that there was a significant association with eye contact and White clients across all racial identity statuses in therapy, and that the therapist’s age was significantly associated with therapeutic experiences, length of therapeutic practice and the belief in working with unintentional racism in therapy. The outcome of this study will have policy implications in terms of clinical practice and supervision.