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Blog #69 What is my consulting style? And how does this influence my patient?

In the realm of behaviour change, graduates must consider various factors to effectively engage patients who struggle with adherence. We cannot expect that our patients will always just be willing to do everything we say or want, just because we have a certificate.

What we say in a consult can influence whether a patient is committed to us and their rehab journey or not? What happens….

You have probably noticed already the clients that are ‘Reactors’. These are the ones that you have done a great consult with loads of information and education and try to lock them into a long-term commitment for rehab. When Reactor individuals perceive a threat to their freedom or autonomy, they experience negative emotions that drive them to restore their sense of control. This can lead to resistance or defiance towards the source of the threat. In physiotherapy, Reactors can manifest as resistance to treatment recommendations, non-compliance, or behaviours that hinder progress.

How do we understand a Reactor?

Recognising and managing a Reactor is critical in physiotherapy as it can significantly impact how you motivate them to adhere to treatment. Patients may resist treatment recommendations or engage in behaviours that undermine their progress, leading to poorer outcomes, decreased patient satisfaction, and a frustrated therapist.

Recognising Reactors can be challenging as it can manifest in various ways. Some common signs and symptoms of Reactors in physiotherapy include resistance to treatment recommendations, non-compliance, and engaging in behaviours that undermine progress. It's essential to differentiate reactance from other forms of resistance, such as fear, lack of understanding, or mistrust.

Effective communication and a positive patient-therapist relationship are crucial in recognising Reactors in clinic. Physiotherapists need to be attentive to patients' verbal and non-verbal cues and take the time to understand their concerns and needs.

Strategies for Managing Reactors

  • Providing choice

  • Explaining and educating patients and checking in on what they think of what you are saying. Don’t wait until the end. Give snippets of info and check in regularly about how they think this will benefit them. This keeps both parties on track.

  • Collaborating with patients on how they see rehab looking for them.

  • Acknowledging and validating patients' concerns and how that plays a role in their recovery.

  • Providing positive reinforcement are effective strategies for managing reactors in physiotherapy.

Physiotherapists must maintain ongoing communication and monitoring of patients' progress and concerns and adjust treatment plans accordingly. It is not a one-off process in the initial consult and never addressed again.

Why Physiotherapists Need to Know About Reactors

Understanding and managing Reactors can improve patient outcomes and satisfaction by increasing motivation and adherence to treatment recommendations. It can also build trust and rapport between patients and physiotherapists, leading to improved communication, collaboration, and patient-centred care. Lastly, understanding reactors can help physiotherapists develop more effective treatment plans and delivery strategies that align with patients' goals, needs, and preferences.

Understanding these types of clients will alleviate stress and frustration when they are not compliant. Not everyone is willing and trusting on Day 1, you will have to prove yourself. Most clients are sick of healthcare being a directive style of care that they are told what to do. They are well informed these days when they present to our clinics and want to have a say and a role in how they are managed. We need to work with our new generation of patients to guide them on their rehab journey and how that looks for them. Despite if they cannot come for as frequent sessions – no worries, it just means we will get the outcomes we want but it may take a little longer. It is all about compromise.


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