Interaction between patient and physiotherapist in psychiatric care: The physiotherapist’s perspective

Gyllensten, A., Gard, G., Hansson, L., & Ekdahl, C. (2000), Advances in Physiotherapy, 2(4), 157-167.

This article was reviewed by Charlotte Hoium, physical therapy doctoral student at the University of Minnesota, 2014.

The article may be obtained free of charge from Dignity-Danish Institute Against Torture by emailing them at [email protected] and including a list of desired articles.

Purpose:  to investigate what factors the physiotherapy experts in psychiatric physiotherapy believed to be important in the interaction between the patient and the physiotherapist. Detailed analysis of the findings, as well as suggestions to improve outcomes in physiotherapy treatments with patients who are being treated by psychiatrists, are made.

Methods:

• Qualitative case studies with use of cross-case analysis
• Framework founded on clinical experiences of psychiatric physiotherapy and results from a study of expert PT’s views of important interaction factors in primary health care

Results:

• Prerequisite dimension — important factors that were thought to underlie what was to take place in the interaction between the patient and the PT
  • Prerequisites of the PT
    • Body awareness
    • Life experiences and values
    • Using own emotions and affects
    • Professional role
    • Education, post-graduate courses
    • Ability to be present in the moment 
    • Patient experiences and practical professional skills
    • Personal characteristics 
  • Prerequisites of the patient
    • Patient resources
    • Patient expectations and hopes
    • Patient emotions and needs
    • Patient characteristics and experiences 
  • External factors
    • Supervision
    • Working environment 
    • Teamwork
• Interaction dimension — themes relating to the actual interaction, and what was taking place in the treatment situation
  • Ways of contact
    • Therapeutic relationship 
    • Encountering 
    • Body language, non-verbal communication 
    • Intuition
    • Listening
    • Motivations and stimulating the patient
    • Taking in the whole
  • Therapeutic process
    • Helping the patient to identify resources 
    • Patient cooperation 
    • Body awareness process
    • Sharing knowledge with patient
    • Confirming the patient
  • Structure of treatment
    • Contact
    • Time
    • Consensus about the problem
• Outcome dimension
  • Outcome
    • Patient awareness of own resources
    • PT improvement of interaction skills with the aid of reflection

Conclusions:

• Role of PT is to guide patient into awareness of and contact with his or her own resources
• Way in which the interaction was carried out and how the therapeutic relationship was formed were considered to be the most important factors
• Body awareness skills and ability to be mentally present in the encounter were important in the therapeutic outcome