Why do physiotherapists and musculoskeletal practitioners need mental health training?
Over the past decade, mental health or rather mental ill health has grown exponentially and this has given rise to a whole range of approaches to treatment. What has this got to do with visiting a physiotherapist or other musculoskeletal practitioners? The Chartered Society of Physiotherapy (C.S.P.) points towards a more multidisciplinary pain management programme (P.M.P.) approach when working with patients who have mental health issues; referring patients on for Cognitive Behavioural Therapy C.B.T., Mindfulness or acceptance and commitment therapy (A.C.T.), which have all gleaned variable results, with greater cost savings than that of physiotherapy alone.[i]
Research suggests that chronic pain is very often linked to physical, emotional and social wellbeing[ii]. It has been generally accepted that patient’s who suffer from chronic pain carry 3 times the average risk of psychiatric disorders[iii]. The chances of your patient having a mental health issue is statistically rising by the day and that’s why you need to safeguard yourself in the first instance.
As a health care professional the physiotherapist needs to be able to asses if the patient is suffering from an acute/chronic physical pain or from an Emotional Memory Image that is triggering a painful psychosomatic response[vi],[vii]. Having the ability to make this therapeutic distinction leaves the physiotherapist with the ability to take action and genuinely help the patient.
Knowledge about the efficacy of these treatments might be important, but not sufficient enough for healthcare professionals to effectively treat a patient. The number of patients are growing daily therefore the scope of treatment must accelerate to an as yet unprecedented level, which is the dilemma that, as health care professionals, we are all facing. There must be a better way…
“Making physiotherapists ready for managing patients with dominant psychological factors might be one of the main challenges for future musculoskeletal research, education and practice”[viii].
The Hudson Mind Process© when applied can give an accurate assessment of the emotional connection to the patients pain in only a couple of minutes, via the use of specific non-verbal communication. This ‘response’ has been codified, so that the health professional can easily correlate the patient’s neurological connection to an emotional trigger. Up-skilling physiotherapists would allow for more of a triage approach to helping patients, so that they can be treated and referred more quickly, therefore affording greater patient care and cost savings.
Why I needed more psychological tools as a physiotherapist
There are so many rewarding aspects to being a physiotherapist. Ranging from helping a patient to be more self-aware so that they can move more confidently, helping them understand how their body works so as to improve their resilience, or maybe to ease their nerves after an injury to let them know that everything is going to be okay.
The most rewarding thing, and I think many physiotherapists will agree with me here, is when you are able to help a patient out of pain, and see them light up when they get back to doing the things they enjoy.
On the flip side of that, by far and away the most frustrating, stressful, and disappointing part of the job, is when you have given a patient everything that you can to help, and it just doesn’t make a difference. Or at best, it helps for a few days. These are the patients that leave you scratching your head at the end of the day, and these are the kind of ‘voids’ that drive your continuing professional development. Added to this is the fact that due to workplace stressors and budget cuts, sometimes one, two or maybe three sessions is all you get, which can really put the pressure on to get a result.
With all of this in the mix, there is usually one word that causes the heart rate to shoot up, and blood pressure to rise, and that is the word ‘CHRONIC’.
These patients have been around all of the hospitals, clinics, and pain specialists, and after they have had a bit of break, they jump back on the roundabout again and land on your door step.
I remember thinking “How can I help people with these chronic conditions in such a small amount of time, when everything else has failed?”
When speaking to some of my more disillusioned colleagues, the advice would be to just give them some treatment, improve their symptoms for a few weeks, maybe a month at best, and then discharge them to ‘self-manage’.
If you are like me, that just isn’t enough.
Fortunately, there is a better way…
Having gone through the Body Mind Workers training, and learned the Hudson Mind Theory, I have the tools to make a real difference.
The Body Mind Workers training significantly improved my communication skills, helping me to build better rapport and communicate in a way that is meaningful for my patients, which immediately led to an improvement in clinical outcomes!!
The Hudson Mind Theory has added a new element to my skillset, it seamlessly fits in to a standard subjective assessment, while allowing me to quickly, easily and effectively ascertain whether a “hands on” more traditional approach is needed, or if a Hudson Mind Process intervention will lead to a resolution of symptoms. It is evidence based, and simple to learn.
This work has allowed me to boost my clinical outcomes and patient relationships, and improved my job satisfaction and overall wellbeing at work.
But most importantly, it now allows me to help those patients that are stuck on that roundabout, endlessly hoping and so often disappointed. The tools provided within the training will help you make the difference in countless people’s lives, and I would strongly urge you to invest in yourself and join the Body Mind Workers.
[i] Jenner, E . (2018). Physiotherapy works: Chronic pain. Available: https://www.csp.org.uk/publications/physiotherapy-works-chronic-pain. Last accessed 24th September 2018.
[ii] Jenner, E . (2018). Physiotherapy works: Chronic pain. Available: https://www.csp.org.uk/publications/physiotherapy-works-chronic-pain. Last accessed 24th September 2018.
[iii] Harvard Medical School, ‘Depression and Pain.’ Harvard Mental Health Letter, September 2004 (http://www.health.harvard.edu/newsweek/Depression_and_pain.htm).
[iv] Zangoni G, Thomson OP. ‘I need to do another course’ – Italian physiotherapists’ knowledge and beliefs when assessing psychosocial factors in patients presenting with chronic low back pain. Musculoskeletal science & practice. 2017;27:71-77.
[v] Foster NE, Delitto A. Embedding psychosocial perspectives within clinical management of low back pain: integration of psychosocially informed management principles into physical therapist practice–challenges and opportunities. Physical therapy. 2011;91(5):790-803.
[vi] Hudson, E.M. (2018). The Hudson Mind Process – Part 1. Available: https://bodymindworkers.com/hudson-mind-process-part-1/. Last accessed 23rd September 2018.
[vii] Bernheim, H (1890). Suggestive therapeutives: A treatise on the nature and uses of hypnotism.. New York: Putnum. p137-139.
[viii] Body in Mind. (2018). Physiotherapists struggle to identify and deal with psychological factors in chronic low back pain. Available: https://bodyinmind.org/identifying-psychological-factors-back-pain/. Last accessed 23rd September 2018.