Individualised and holistic care are the notions at the heart of a therapeutic relationship. Buckle (1993) defines holism as “The concept of wellness and state of harmony between mind, body and spirit”. Holistic nursing aims to take care of all factors of health and illness, spiritual, physical, psychological and sociological. Pearson (1994) supports the view that holistic care treats the whole person, rather than just the symptoms of a disease or illness. A therapeutic relationship is helpful in promoting holistic care as assessment and care planning which occur as an integral part of the relationship, can be tailored individually to include all aspects of a person’s needs. Assessment could be viewed as the starting point in the therapeutic relationship. It is a complex and responsible process the ethics of which require us not to make assumptions or dismiss what our patient says. From assessment we can determine patient attitudes, spiritual and religious beliefs and values, we begin to discover their needs, the amount of involvement, and how much information they may wish to have in their care. When considering biological aspects of care it is essential to include factors, which may affect assessment, planning, and implementation of nursing care. The human body consists of an elaborate structure of cells and tissues, which combined make up our biological systems. Only when performing assessment do we look at the systems in isolation, for example Musculoskeletal system when assessing mobility, this assessment together with our psychosocial needs form the basis for holistic care. Assessment requires good communication and observational skills in order to formulate a complete and individual care plan.

Communication is perhaps the most important contributing factor in a successful therapeutic relationship; humans are social beings and spend a large part of each day communicating with each other. What exactly do we mean by communication? Schroeder (1999) suggests communication is any form of message, which has been sent, received and understood. Communication is much more than just the spoken word, it involves body language, facial expression, eye contact and hand movement, good communication is about listening to patients and understanding their fears and expectations. Nichols (1993) advocates effective communication as a “Positive contribution to an individual’s recovery by acting as a buffer against fear and confusion”. Garnham (2001) indicates the need to be aware of barriers to effective communication including making assumptions, and being aware of the