At its core good physiotherapists know how to coach and motivate behaviour change. Whether it be taking something away (often the case) or adding something new, learning skills for behaviour change are invaluable.

Changing pain often requires changing habits. It is up to us to listen well, find motivators and provide our clients with the tools they need to succeed.


First
Listen

Listen more than you talk. Many years ago, esteemed physiotherapist Professor Maitland, encouraged therapists to listen actively. He suggested that if a therapist listened well enough the answers to the client’s problems would be provided. Once you have heard your client’s story provide explanations and education that fosters collaboration and a shared understanding of the plan. Clients who understand their condition feel in control are more likely to succeed. The best therapists promote component and independent health clients.

 

Second
Increase motivation and ability

fogg-behavior-model

 

 

 

 

 

 

 

  1. Increase Motivation
    1. Find meaning in the exercise
    2. Set goals pertaining to this meaningful act
    3. Set a time parameter
  2. Increase Ability
    1. Give them tools
    2. Make them smarter
    3. Make it easy
    4. Routines
    5. Follow up
  3. Identify Triggers
    1. Tie it to an existing habit. Ie: brushing teeth, taking a phone call, sending an email

Third
Start with the end in mind.

Look for intrinsically motivated goals and refer back to them. “You are doing this because it will strengthen this and get you back to…”

Set out a contract and commitment to a plan. Make sure you are on the same page as your client. Write out a clear plan of action and get them to commit to the plan.

Allow people to experience both failures and successes. Encourage them when they succeed and allow failures to happen occasionally. Intervene when necessary to enhance the session. The amount you intervene will vary from client to client so read cues and provide the appropriate amount of feedback.

So much of our focus is on hands on treatment and physical capabilities but in my mind the thing we could all work is our ability to coach and motivate people to better health. If we can do this we can change health care for the better.

Image from: BJ Fogg. His work, amongst others, has helped me transform the way I work with clients.

I used these notes when I spoke to the UBC Neuro Club.

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