PSYCH - PSYCHOLOGICAL CARE IN PHYSICAL THERAPY

an understanding or attunement

Empathy

the ability to enter clients’ frames of reference and understand their situations and feelings from their point of view.

Empathy

the congruence, realness, or authenticity

Genuineness

therapists are aware of and honest about their feelings and attitudes.

Genuineness

unconditional positive regard, respect, liking, or prizing

Acceptance

therapists accept clients for who they are, regardless of any behaviors, attitudes, or feelings demonstrated by the clients.

Acceptance

T or F

By expressing empathy, the therapist may project his or her personal concerns onto the client, thus inhibiting the client’s expression of feelings.

False

should be sympathy

_____ often shifts the emphasis to the therapist’s feelings, hindering the therapist’s ability to view the client’s needs objectively.

Sympathy

T or F

Posture, proximity, touch, body movement, gestures, facial expressions, eye contact, tone of voice, use of time and space, and even physical characteristics are all under the attending skills

False

they’re under the non-verbal communication and attending behaviors

Open and closed questioning; empathetic listening

Attending skills

position and proximal space is under what type of non-verbal communication?

Proxemics

Proxemics is the study of distance zones between people during communication.

Give the 4 types of non-verbal communication under Kinesics

Facial expression

Touch

Posture

Gestures/Mannerisms

Particular vocal characteristics, such as tone of voice, speed of speaking, and volume

Paralanguage - Paralinguistics

The human face produces the most visible, complex, and sometimes confusing nonverbal messages.

Facial expression

T or F

Touch is a key skill in a physiotherapist’s role for both diagnostic assessment and treatment.

True

T or F

Posture is a barometer for feelings

True

_____ is useful in emphasizing ideas, in creating and holding others’ attention, and in relieving stress

Gestures/Mannerisms

Type of Proxemics

12-25 ft

Public space

Type of Proxemics

0-18 in

Intimate space

Type of Proxemics

18-36 in

Personal space

Type of Proxemics

4-12 ft

Social Space

systematic study of the body and the use of its static and dynamic position as a means of communication

Kinesics

Congruency between the verbal and non-verbal expressed language.

Nonverbal cues appear in groups

Two key points to Successful Nonverbal Communication

False

Clustering

Reordering is the grouping of gestures, facial expressions, and postures into nonverbal statements

Facial Expression (just read)

T or F

limbs open and facing the patient shows closure and avoidance

False

limbs crossed over one’s chest - closure and avoidance

leaning back in a chair with the arms up and hands clasped behind the head shows openness to suggestions

True

slumped shoulders often signify _____

Depression

Awareness of ______ is useful when identifying a patient’s opinion and includes words and figures of speech.

Linguistics

Take note of ambivalence towards their self efficacy (e.g. “I don’t know if I can do…”)

Linguistic aspects such as timing, volume and tone, alongside nonverbal cues are useful to be aware of

False

Paralinguistic aspects

they will also indicate and give insight to the opinion and thoughts of the communicator

T or F

For communication to have any meaning, it must be understood by all parties to the communication

True

5 Cs of Communication

Complete

Clear

Concise

Cohesive

Courteous

act of paying attention to the therapist’s own thought processes and being aware of what the patient is saying in the background is under what zone?

Zone 2

therapist is theorizing and interpreting what is happening to the patient is under what zone?

Zone 3

act of listening to the patient and attending to linguistic, paralinguistic and nonverbal aspects is under what zone?

Zone 1

Ways of Empathetic Listening

a response to a client’s communication used to ensure that the practitioner has heard what the client said accurately.

Paraphrasing

Ways of Empathetic Listening

T or F

Summarization is used when physical therapists sense that there is a lot of emotion connected with a client’s injury or recovery process that is not being expressed verbally

False

Reflection of Feelings

Ways of Empathetic Listening

T or F

Summarization tries to capture the essence of a longer period of communication.

True

Therapeutic Communication Techniques (Read)

Therapeutic Communication Techniques (Read) p2

Therapeutic Communication Techniques (Read) p3

Therapeutic Communication Techniques (Read) p4

Therapeutic Communication Techniques (Read) p5

Therapeutic Communication Techniques (Read) p6

Ineffective/ Inappropriate Responses and Behaviors

Fear of ______ and of being injured is a concern with the few patients who do not respond to staff efforts at verbal diffusion of anger.

Violent behavior

T or F

You should reinforce and argue with a patient’s delusions/ hallucinations

False

Do not reinforce; arguing with a patient about delusions/hallucinations is ineffective and inappropriate. Focus on the feelings

T or F

Therapist should understand the patient’s point of view as the patient sees it.

True

Conflicting Values - Encourage patient to examine the effects or outcomes of their beliefs on their lives, relationships and happiness.

T or F

Crying should not be allowed and encouraged, verbally and nonverbally if a patient is expressing vulnerable emotions

False

Unless it is a manipulative gesture or is prolonged and unproductive, that’s when you don’t tolerate it

Privacy should be provided.

When a patient exhibits _____ & lack of ____, listening, clarifying and verbalizing thoughts that have been implied are appropriate for identifying the underlying causes of a lack of cooperation

Denial & Lack of Cooperation

Measures to increase trust and a great deal of patience from the therapist are needed

Common ________ are a means to gain attention, sympathy, control and dependence.

Manipulation

PT Approach: Limit setting – setting appropriate boundaries

Patients with severe _______ and incoherent speech patterns who have disturbed thought process: patients who are upset, confused or psychotic

Severe anxiety & incoherent speech patterns

Approach: clarify the meaning of the communications

Severely _______ patients might be unable to be clearer

Ill/ anxious

PT approach: key into their feelings and underlying themes, rather than trying to make sense of the content of their speech.

T or F

Patients who expressed sadness, helplessness, hopelessness, lack of energy, or a negative attitude about everything present with Depressed Affect, Apathy or Psychomotor Retardation

True

PT approach: use patience, frequent contact and empathy; encourage gradual increase in activities

These patients should be in quiet area, with minimal auditory and visual stimulation. The therapist must remain calm, speak slowly and softly, and respect patients’ personal space.

Hyperactivity (Hyperactive patients)

This behavior might cause the patient to be afraid of everyone

Suspiciousness

Approach: communicate clearly, simply and congruently; clarify misinterpretations by patients, but avoid arguments over differences in opinion

T or F

Transference might occur in response to a patient’s transference.

False

Countertransference might occur in response to a patient’s transference.

______ involves the unconscious emotional reaction that patients have in a current situation that is based on previous relationships and experiences

Transference

Therapists must examine their strengths, weaknesses, prejudices and values before they can interact more appropriately with patients.

Physiotherapy is widely recognised as a ‘hands on profession’ and physiotherapists work in a manner in which they are in close physical proximity to patients

Sexual Innuendos or Inappropriate Touch

The physiotherapist may need to examine their communication with a patient.

Erotic transference & countertransference