Moving the Bar: PART 1: Preparing Yourself for Patient-Clinician Interaction

CHAPTERS WITHIN THIS SECTION INCLUDE

• Chapter 1 Establishing the Therapeutic Alliance 19

• Chapter 2 The Mechanics of Movement 42

• Chapter 3 Special Environments 61

INTRODUCTION

The essence of therapy occurs in the interaction between the clinician and the patient. A significant component of this interaction, however, can and should take place before the clinician ever comes into contact with the patient. Preparing for each patient interaction by reflecting on what we bring to it greatly facilitates the quality and success of our therapeutic activities.

As described previously, we can view our patients and ourselves as dynamic systems: each of us is a person engaged in a task within a particular environment or situation . Part of the power inherent in a dynamic system comes from the reality that a change in one area creates a change in another area. Preparing ourselves in any one area can therefore increase the likelihood of success in all other dimensions of therapy. Chapters 1, 2, and 3 provide specific “how-to” information for bringing your best to the patient, the task, and the environment. Chapter 1 offers guidelines for thinking about and communicating with clients. Chapter 2 describes how to use your own body as an effective biomechanical instrument in movement tasks. Chapter 3 introduces a variety of environments in which patient care takes place.

Preparing for Personal Interaction

Awareness of Values and Beliefs

The best place to begin is the area where we have the greatest control and influence—ourselves. We bring to every patient task, consciously or not, a set of values and beliefs and a bank of prior experiences from which we draw moment by moment. These values, beliefs, and experiences shape our patient care by filtering the information we perceive and respond to and by directing our choices of action—in short, shaping the nature and quality of the therapy experience we offer to the patient.

Many of our beliefs and values are good. For example, the belief that it is good to be compassionate toward people who are vulnerable and hurting most likely played a part in your choice to become a health-care professional. In the clinic, that internal conviction might cause you to take extra time with a frightened child who is being treated for burns. In such a case, valuing compassion over efficiency allows a positive, healing interaction to take place.

As long as we are interacting with people from a similar culture or background, we may be unaware of the beliefs and values we hold. Unfortunately, when we encounter people whose values and cultural practices differ from our own, the cognitive dissonance is likely to elicit a judgmental response on our part. The good news is that, at the moment our assumptions become visible to us, we have ...