As the 100 million people in the U.S. who live with ongoing pain can likely attest, the condition exists at the top of a slippery slope that, over time, can pull chronic pain sufferers into a struggle that only serves to accentuate the pain.
Yet, despite being touted as an effective and affordable solution to chronic pain, physical therapists are typically not equipped to address many of these challenges – specifically as they relate to psychological and psychosocial factors that may stand in the way of helping individual patients achieve positive outcomes.
As we’ve discussed in previous posts, the psychological impact of living with chronic pain – issues that are associated with anxiety and depression – is largely unaddressed through biomedical interventions.
Yet, these psychological factors should be a key focus for pain practitioners who are intent on helping their patients lead fulfilling, meaningful lives while returning them to a more active lifestyle.
Such is the goal of practicing psychologically informed care at your physical therapy clinic.
Psychologically Informed Physical Therapy: What is Psychologically Informed Care?
Psychologically informed care (a.k.a., psychologically informed practice or psychologically informed physical therapy) is a bridge between a standard PT practice based on biomedical principles and the more cognitive-behavioral approaches originally developed for the treatment of mental illness.
A main goal of psychologically informed care is having the ability to identify psychosocial signs (known as “yellow flags”) in a patient which may affect his or her treatment outcomes. Yellow flags can be fear avoidance behaviors, beliefs, mood, pain levels, negative perceptions, etc.
Once identified, psychologically informed physical therapists would then modify treatments to improve outcomes – treatments that better align with these psychosocial factors.
“The goal, therefore, is to not only treat the individual for current symptoms, as has been the traditional role of the physical therapist, but also prevent the development of unnecessary pain-associated activity limitations,” wrote Chris J. Main and Steven Z. George, authors of “Psychologically Informed Practice for the Management of Low Back Pain: Future Directions in Practice and Research,”published in the May 2011 edition of Physical Therapy Journal.
“This goal,” they added, “may involve not only clinical management at the level of the individual patient encounter, with increased consideration for psychological factors, but also to the manner and context of service design and delivery, incorporating appropriate incentives for the management of psychological factors.”
Physical Therapists Uniquely Positioned
According to Main and George, physical therapists are well-positioned to identify and address such psychological risk factors, or yellow flags. Yet typically, physical therapy education and practice focus solely on biomedical.
Because of this, physical therapists often simply don’t feel well-equipped to deal with psychological factors when it comes to pain, despite the potential for improved outcomes.
Enhanced knowledge of these psychological factors, according to Main and George, should be a goal for all physical therapists who treat chronic pain sufferers and who wish to stand out in their markets.
“The shift in focus necessary to include routine consideration of psychological influences is, in our view, the logical extension of an evidence-based secondary prevention approach within standard physical therapy practice,” they wrote. “Psychologically informed practice has the opportunity to improve clinical and occupational outcomes through appropriate consideration of relevant psychosocial factors.”
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At the Integrative Pain and Science Institute, we’ve responded to this call for the need to psychologically informed care by offering education and training that allows physical therapists to feel confident in assessing psychological factors when treating chronic pain.
By learning to identify potential yellow flags in a patient, then altering their treatments accordingly, physical therapists and their patients will begin to see improved, more long-lasting outcomes that truly make a park of people’s lives.
Offering such well-rounded care and treatment can, of course, also set your clinic apart within your local market.
Click here to learn more about psychologically informed care, or click here to reach out for more information about psychologically informed care and how this approach can improve your patient outcomes.
