An innovative session at next year’s WCPT Congress in South Africa will use roleplaying to show therapists how they can consistently encourage patients to live healthier lives.
The focused symposium aims to complement clinical reasoning skills with a practical approach to biopsychosocial questioning, so that therapists can encourage patients to adopt healthier lifestyles. Dr Anne Söderlund, who will chair the session, explains that the understanding of psychosocial approaches has increased – but can only go so far without a systematic introduction to practice.
“The awareness is really there now,” she says. “And that is good, because that is the beginning of the change. We are doing each part as a roleplay. We are using the tools, we are giving the knowledge, and then we’re going to try something concrete. Because this is one of the problems: I know what I should do, but how do I do it?”
According to Dr Söderlund, the tendency has been for therapists to zero in on patients’ difficulties with mobility or function without consistently asking about sedentary behavior, low levels of physical activity or unhealthy lifestyles which might have created the very problems that therapists are expected to solve.
“In most countries we are educated to solve the problem,” she says. “Patients come to the clinic and say, ‘My back is hurting when I bend’. And the therapist is very much already doing the clinical reasoning in their head, diagnosing during the discussion. Because they go directly to the problem-solving, they don’t analyse the whole situation for the patient.”
The session follows a well-attended event at WCPT 2015 in Singapore which looked at promoting health-based practice competencies and evidence-informed assessment tools. In Cape Town the roleplaying session consists of four parts with demonstrations of assessment tools and psychosocial strategies, as well looking at how member organisations can integrate health promotion into clinical practice and education.
In day-to-day practice therapists use an array of techniques to encourage behavior change, including self-monitoring, goal-setting and feedback. However Dr Söderlund contends that even this is not happening consciously enough to maximise the potential benefit for individual patients.
“It is happening unsystematically,” she says. “Physiotherapists don’t know what they are doing, in that when they give a patient an exercise diary they are not really reflecting on the fact that this is something that should lead to behavior change. There is so much more to gain from the behavior change point of view if we were to do these things consciously.”
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