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  • Pamphlet 2: the role of therapist

    I put this together quickly. It is a skeleton only. What do you think?
    Attached Files
    Cory Blickenstaff, PT, OCS

    Pain Science and Sensibility Podcast
    Leaps and Bounds Blog
    My youtube channel

  • #2
    Cory, I am not sure I would use "Magician" or "Guide" with my population. The whole comparison exercise seems like rather hard cerebral work for the patients, after already having had to absorb quite dramatic new stuff about their pain...I would add "awareness" in the paragraph "These are used to bring relief, awareness, improve quality (etc)".

    I think by keeping the pamphlet straight up and simple, it leaves the PT to embellish, illustrate, use analogies or similies - individually tailored to each patient.

    "Gentle motion may help nerve oxygenation and may shut off some hypersensitive nerves. This gentle motion can be elicited by the therapist's hands, and/or you can be helped to discover your own instinctive helpful (therapeutic?) motion"

    "The therapist will be helped you learn to do this by yourself, so you can influence your recovery even more"


    How's that? - Other ideas?
    We don't see things as they are, we see things as WE are - Anais Nin

    I suppose it's easier to believe something than it is to understand it.
    Cmdr. Chris Hadfield on rise of poor / pseudo science

    Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

    We don't need a body to feel a body. Ronald Melzack

    Comment


    • #3
      Hi Cory. I´m agree with Bas. I think I would not use "Magician" with my patients.
      Javier González Iglesias

      Comment


      • #4
        I'm also wary about the word 'magician'; I know what it implies in the context of what Barrett has written, but how would it be construed by other PTs? and patients often talk about a therapist's magic hands; I think they are implying there is no known reason for a therapy to 'work'. Somehow I sense confusion about what we are telling them about the reality of pain physiology and 'magic'.

        Examples:
        "A therapist can assist you in the process of moving naturally without pain." or
        "The most effective therapy often comes from within yourself, and the therapist can help you achieve this."

        And I would like to see the word 'awareness' included, along with the assurance that they do not need complex exercises and stretches to try and fit into their day. Quite a few expect and want them, but we can offer an alternative.

        Nari

        Comment


        • #5
          I was thinking along the lines of what a therapist does vs. is.
          Educate, Manual care, Movement (any other's/better terms?) Leaving it general enough to accommodate a wider variety of PT but explaining under the headings enough to have the interventions make sense with current pain science and relate to the first pamphlet.
          Christopher Bryhan MPT

          "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
          Daniel Kahneman - Thinking Fast and Slow

          Comment


          • #6
            I agree with Nari et al.
            How about writing this into your pamphlet on the therapist's role:
            [quote]
            Our brain can be, for simplicity sake, broken down into 2 animals. One spends its time thinking about and dealing with the present...what is in front of it at the time. The other spends its time thinking about and dealing with what will happen in the future.

            The former is reactive. It happens largely without our knowledge of it, but it reacts to the current state of things. The latter is planning. It uses past experience to plan for what to expect in the future and how it should be handled.

            The reactive brain acts out in terms of need states. It motivates us to fulfill the needs brought about by the present and its reaction.

            The planning brain acts out in terms of goal states. It motivates us to meet the goals it has set for us to meet.

            Our reactive brain is built for immediate survival while our planning brain is built to handle long term survival. If we are acting primarily in terms of the reactive brain, we may not meet the needs of the planning brain, and vice versa. In order to meet the need state and the goal state simultaneously they must be made relevant to each other.

            Part of your therapist's role is to introduce these two aspects of your system to one another and help them learn to get along better.
            Diane
            www.dermoneuromodulation.com
            SensibleSolutionsPhysiotherapy
            HumanAntiGravitySuit blog
            Neurotonics PT Teamblog
            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
            Canadian Physiotherapy Association Pain Science Division Facebook page
            @PainPhysiosCan
            WCPT PhysiotherapyPainNetwork on Facebook
            @WCPTPTPN
            Neuroscience and Pain Science for Manual PTs Facebook page

            @dfjpt
            SomaSimple on Facebook
            @somasimple

            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

            Comment


            • #7
              I edited out the magician bits, and ended up with this so far. Still lots more space left.
              Attached Files
              Diane
              www.dermoneuromodulation.com
              SensibleSolutionsPhysiotherapy
              HumanAntiGravitySuit blog
              Neurotonics PT Teamblog
              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
              Canadian Physiotherapy Association Pain Science Division Facebook page
              @PainPhysiosCan
              WCPT PhysiotherapyPainNetwork on Facebook
              @WCPTPTPN
              Neuroscience and Pain Science for Manual PTs Facebook page

              @dfjpt
              SomaSimple on Facebook
              @somasimple

              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

              Comment


              • #8
                I'd like to see a bit of this:

                "Another result from this education and assistance from your therapist: you will feel more empowered. This is a different "state-of-mind"; it has significant effects on the actual function of your brain and glands, which may well result in increased relaxation and painrelief.
                With the additional focus on awareness of breathing patterns and danger-free motion, your neurological system will already undergo major changes - a reversal of its present "alarm-state" to a more calm and easy state".
                We don't see things as they are, we see things as WE are - Anais Nin

                I suppose it's easier to believe something than it is to understand it.
                Cmdr. Chris Hadfield on rise of poor / pseudo science

                Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

                We don't need a body to feel a body. Ronald Melzack

                Comment


                • #9
                  Bas, take the pamphlet, put in what you want, and reattach it. (Need any help attaching it?)
                  Diane
                  www.dermoneuromodulation.com
                  SensibleSolutionsPhysiotherapy
                  HumanAntiGravitySuit blog
                  Neurotonics PT Teamblog
                  Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                  Canadian Physiotherapy Association Pain Science Division Facebook page
                  @PainPhysiosCan
                  WCPT PhysiotherapyPainNetwork on Facebook
                  @WCPTPTPN
                  Neuroscience and Pain Science for Manual PTs Facebook page

                  @dfjpt
                  SomaSimple on Facebook
                  @somasimple

                  "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                  “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                  “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                  "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                  "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                  Comment


                  • #10
                    Thanks Diane, here's my first try. (BTW, I have strictly for my own purposes, kept it very straight and rather dry)
                    Attached Files
                    We don't see things as they are, we see things as WE are - Anais Nin

                    I suppose it's easier to believe something than it is to understand it.
                    Cmdr. Chris Hadfield on rise of poor / pseudo science

                    Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

                    We don't need a body to feel a body. Ronald Melzack

                    Comment


                    • #11
                      I’ve been thinking a bit about Csikszentmihalyi’s concept of flow and how it might work into a section in the therapist's roll pamphlet (although it seems to blend into the patient’s roll as well).

                      For flow there are 3 things necessary
                      1. A clear challenge that fully engages attention
                      2. Skills to meet the challenge
                      3. Immediate feedback of how you are doing at each step

                      So for #1: The challenge is pain and if pain education has been successful the patient will see this not as a challenge to fear, but to embrace and move toward resolution vs. withdrawal. Which leads to #2: Skills to meet the challenge. We are born with the skills to instinctively resolve pain, but through social learning or injury and learned protection the skills may be suppressed. The therapist helps catalyze and awaken the awareness of these skills through manual contact or verbal communication. #3 immediate feedback. The therapist helps the patient to monitor the nervous systems response to the treatment intervention. With education and practice the patient becomes aware of the characteristics of successful movement to reduce mechanical deformation and can provide self feedback.

                      It is ultimately the job of the patient to learn this process independently and learn to let their nervous system manage pain as only it uniquely knows how to do. The therapist merely makes the patient aware of this process.

                      Any thoughts? Could probably be cleaned up/simplified with bullets.

                      I can't get into the word documents, so if this has been said I apologize.

                      Chris
                      Last edited by christophb; 03-08-2007, 01:02 AM.
                      Christopher Bryhan MPT

                      "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
                      Daniel Kahneman - Thinking Fast and Slow

                      Comment


                      • #12
                        I am not sure I would use "Magician" or "Guide" with my population.
                        Hi Bas,
                        I'm not sure I would either. I was thinking in terms of how we are perceived based on therapy's reputation...someone to tell me what to do (guide), someone to fix me (magician), or someone to help me figure it out for myself (teacher). I think I get all three of these preconceived notions in the clinic and have to address the mindset of each to proceed.

                        That said, I agree with you all and like the direction it's going.
                        Cory Blickenstaff, PT, OCS

                        Pain Science and Sensibility Podcast
                        Leaps and Bounds Blog
                        My youtube channel

                        Comment


                        • #13
                          I've got a question. It seems that the focus of this pamphlet isn't so general as to be an attempt to describe what physical therapists do but rather the role of PT as it relates to pain. Is that pain in general regardless of other presenting problems?
                          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                          Comment


                          • #14
                            Good question... I was thinking pain secondary to mechanical deformation. Would it be better to be more general?
                            Christopher Bryhan MPT

                            "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
                            Daniel Kahneman - Thinking Fast and Slow

                            Comment


                            • #15
                              I think it is important to firstly ask ourselves, how does it benefit a patient to understand the role of the therapist?. Describing what I should be doing and its beneficial effects feels more like I'm trying to sell something than educate. I'm not sure patients really want or need to know what my job is. They want and should know what their role in the relationship is, eg self-efficacy, changing beliefs, attending to instinctive responses, all stuff that is probably better placed in a patient education pamphlet.

                              Just a thought.
                              Luke Rickards
                              Osteopath

                              Comment

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