The Monday Memo
January 9, 2017 PITT DPT STUDENTS
Psychology and Physical Therapy
Physical therapy is a profession that relies heavily on relationships. The psychology behind human interaction and health care plays a critical role in the success of our interventions. Today we’ll touch on two incredibly important relationships: The patient /therapist relationship, and the relationship between the patient and their own self-image.
Patient / Therapist
Obviously, patient/therapist interactions play a major role in the effectiveness of therapeutic interventions. It’s imperative that the therapist fosters a therapeutic environment where the patient feels comfortable and cared for, encouraged, and empowered to take an active role in their treatment. The psychosocial aspects of healing are undeniable: There is plenty of research that shows the psychological state of the patient will dictate how effective evidence-based protocols will be. This is one of the reasons why a risk factor for becoming a chronic pain patient is a high Fear Avoidance Belief Questionnaire score. Our mind matters.
As therapists, we often focus too heavily on selecting the “correct” protocol and interventions. Remember that there are always multiple paths to a given destination and it can often be more useful to choose a protocol that the patient believes in to foster a psychologically supportive environment rather than solely the therapist’s choice. This is a tactful way to generate patient buy-in and trust, and may open the door for you to sample your more desirable protocols later on in the process. This is not a call to use unscientific methods, but instead encouragement to use your clinical judgment in deciding which interventions will work best for the individual patient in front of you.
Patient / Self-Image
This relationship is one where the therapist may have the least control, but a proactive approach to assisting the patient in this capacity can go a long way. I’m not advocating the therapist plays the role of counselor, but I am suggesting that the environment you create, the words you choose, and the actions that you take will affect the way the patient feels and the therapeutic benefits of your session.
One of the reasons I chose to pursue a career in physical therapy is that I wanted to play an active role in providing patients with the tools to fix themselves. Patients need to understand that what they do away from therapy is, in many cases, more important than what they do while in your office. We give them the strategies. We provide them with activity modifications. We provide the framework for the patients to take control of their condition and actively “fix” themselves. If we can also foster a psychological environment of self-belief and positive thinking, our patient compliance and intervention success will be greatly improved.
This post simply scrapes the surface when it comes to the psychological influences of our profession. It’s an aspect of therapy that we need to contemplate every single day with every single one of the patients we see. It’s our job to achieve a grasp of our patient from a pathoanatomic perspective and a psychological perspective, and design our interactions and interventions tailored towards the patient in front of us. Each patient will present differently and the mark of an expert clinician is the ability to adapt and adjust in order to achieve positive outcomes for all of our patients.
-Charlie Badawy, Class of 2019
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