C07 – Person-Centered Care in Physical Therapy: An Exploration of practitioner Beliefs, Psychosocial Treatment Approaches, and Implications for Integrated Care Collaboration

Summary

Psychologically-informed physical therapy (PIPT) is a growing treatment approach that recognizes psychosocial factors and their influence on patient outcomes. However, the psychosocial skills needed to improve PIPT is unclear. The Patient Centered Observation Form (PCOF) defines provider behaviors that demonstrate psychosocial skills. Training and application of these behaviors is expected to improve person-centered communication, engagement, adherence, satisfaction, and health outcomes. Healthcare practitioner beliefs centered on biomedical causes of disease may be a barrier to adoption of psychosocial behaviors. This study was a collaboration between psychology and physical therapy to examine the relationship between psychosocial behaviors and practitioner beliefs in physical therapy care. This study acknowledges physical therapists as frontline workers attending to restorative and rehabilitative needs of the human body. Doctoral psychology interns observed licensed physical therapists in five different outpatient settings during physical therapy encounters (n=41 encounters). Outpatient settings also included rural and urban areas. Psychology interns tracked psychosocial behaviors on the PCOF. Therapists were also administered the Physician Belief Scale (PBS), a self-report measure that captures provider beliefs regarding psychosocial factors. Physical therapists in outpatient settings demonstrated the most psychosocial skill in the following PCOF categories: 1) Establishing Rapport; 2) Gathering Information in the form of open-ended questions; and 3) Maintaining relationship throughout visit. The same therapist sample also demonstrated a strong association between practitioner beliefs and PCOF scores. This is the first study to directly observe PIPT behaviors in physical therapy clinics. The findings indicate specific psychosocial behaviors that physical therapists utilize, as well as behaviors to adopt. This study also has implications for future conversations, trainings and studies, to strengthen and complement the ongoing innovation of integrated care.