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As a future physical therapist, you will soon be joining a profession dedicated to the improvement of quality of life, which is broadly defined as the degree to which one derives life satisfaction. Obviously this definition suggests that quality of life is a multidimensional construct that includes elements related to physical, emotional, and psychological well-being.

As you know, entrance into the physical therapy profession requires an intensive course of rigorous academic training to assure your competence in the evaluation, diagnosis, and treatment of the spectrum of diseases and conditions that limit movement and function. The theoretical basis of this training derives from a growing number of scientific disciplines including anatomy, physiology, and biomechanics. Accordingly, the unique application of these skills in the context of patient management has often been considered as the science of physical therapy. Furthermore, the validity and clinical efficacy of these skills can be supported through scientific inquiry and evidence, the consummate “holy grail” by which the value of our professional interventions is measured.

Proficiency in our scientific body of knowledge, while inarguably crucial to professional success, is of little value unless it is embedded in the context of a respectful, supportive, and empowering therapeutic partnership. In order for this partnership to succeed, another set of skills is also critical, and many of these involve effective communication. In the practice of physical therapy, we are called to communicate numerous virtues to those we serve and with whom we work. These include empathy, compassion, encouragement, and optimism. In order to exude these qualities with any level of authenticity within the broader context of health-care delivery, (e.g., in our workplace, profession, and society at large), we must finesse our communication on many distinct but overlapping levels. Furthermore, in order to maintain the passion needed to empower our patients, we must continually stoke the fires of engagement. This too involves proficiency in our interactional skills.

Because these virtues cannot be objectified in the typical language of scientific research, they have become known as the art of our profession. This distinction should not be misconstrued to imply a lesser level of importance, but without a substantial body of evidence (or even an idea of which disciplines to examine in order to find it), we have perhaps conveyed this impression by default, leaving our future practitioners to develop these skills on their own. This is an unfortunate predicament and my central reason for writing this book.

This text addresses communication from a comprehensive theoretical perspective involving three levels of communication (internal, external, and instrumental), which evolve from the inside out. Wherever possible, evidence is provided to support this perspective. In many cases, the work in this text is the author's attempt to present and integrate existing or emerging concepts in a unique and hopefully useful way.

In presenting this theoretical model, the first step was to explore communication from the standpoint of other disciplines who also view it as an important element in quality of life. To that end, much of the research in this text is from the realm of psychology, where quality of life is measured by levels of resilience, optimism, and self-efficacy. Evidence from this discipline supports the text's central premise that these attributes are shaped and conveyed in our communication. In addition, the professions of nursing, education, and organizational behavior have also yielded a rich harvest of information that can serve to enrich our understanding of the complexities of communication.

As our marvelous physical therapy profession continually expands its body of knowledge, it is my sincere hope that the contributions of these disciplines will be better understood and appreciated. Our mission to enhance quality of life in all areas of our scope of influence (namely, personal, professional, and social) stands to benefit enormously.

In the hope of perhaps assisting this process, I am honored to present this text.

Karen Mueller PT, PhD

Professor Northern Arizona University, Program in Physical Therapy

Flagstaff, AZ

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