Our roles as physical therapists is constantly changing & seems to differ extraordinarily depending on what type of patient population you see. Currently, I see A LOT of chronic pain. If someone presents with chronic pain, usually this means the traditional medical model of care will not suffice. In these situations, it is important to use the biopsychosocial model of care if I plan to be successful. Part of the biopsychosocial model is understanding what barriers a person has to therapy. By addressing these barriers, the therapist will best be able to address impairments in the scope of the patient's life. Also by looking at these barriers, you will be able to see if a patient is ready for physical therapy. "Ready" you may be asking yourself? One reality I quickly stumbled across while practicing at a community hospital is that certain people have so many life stresses that take priority before their musculoskeletal health. If a patient comes to see you with cLBP, but also has a history of depression, transportation issues, financial problems, family problems, and reports little to no exercise, strengthening the PGM may not be the first thing they need. I would recommend starting this patient on a general exercise program and a few basic exercises. Going back to barriers, one of the biggest barriers I face each day is patient adherence and compliance. I often struggle with how to address these issues. Which clients are appropriate for PT and which are unfortunately not ready to change? Check out this post by Chris Johnson. He poses some great questions that will put you and the patient on the same level regarding your goals and their expectations of physical therapy. They may save you some time down the road.
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