" You have a pretty major problem going on right now that needs to be addressed."
"There's definitely some work that needs to be put in here, but your outcome looks good."
Or: "Sorry, we're gonna need to cut it off."
Both are fairly common kinds of attitudes that clinicians - whether it's an Athletic Therapist, chiropractor, or physiotherapist - take towards their clients. There's a difference, however. The first instills more fear and dependence on the practitioner; the second generates more optimism and empowerment toward a positive outcome.
This sort of topic traces back to my previous post about honesty and transparency when working as a clinician. As healthcare practitioners, there is a responsibility on our part to deliver information to clients in a way that is going to encourage them to progress in their treatment rather than instill fear and avoidance habits of their conditions.
We've all seen this tactic used distastefully, in that a practitioner will use fear-mongering language in order to create a sense of dependence for the client to constantly keep coming back, which is poor ethical practice indeed. However, it's incredibly easy for well-meaning professionals to unintentionally do the same as well. Fairly enough, someone's back injury might really be a major problem. It's just important to remember that the message that we send, though, dictates the client's belief and self-efficacy when it comes to being able to recover from those injuries.
At the end of the day, it's an easy concept to understand. For instance, with one client of mine who has chronic stress and anxiety that causes her to be unmotivated to do her rehab exercises, my instructions to her this: Do not think, "I have to do the exercises, but I'm not feeling well enough," but rather, "I'm not feeling well, but the exercises will make me feel better."
Psychology 101: Positive reinforcement.
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