How The Clients Psychological State Impacts Recovery

From my time as a Graduate Sports Therapist, I have worked with many clients from different sporting backgrounds and level of abilities. The variety in clients that I see have encouraged me to start blogging. Once I decided to start blogging, I asked myself the question, "where will I start?" So why not start with something that I have found to have had a huge importance in a clients recovery. It is the Biopsychosocial model, but even more interesting for me is the importance of the Psychological section of the model when treating a client. The Biopsychosocial model was constructed by the late George Engel and is still very valid today. See you can have the exact same ankle sprain on an x-ray & use the exact same rehab & protocols and still see different results and time scales for each, the question for many is, why? For me the main thing that differentiates each case study so well, is this model so thanks George Engel! Before Engel's model practitioner's we're using what was called the Biomedical model. It was much like having a Nokia 3210 back in 1999. Everyone was happy using it, it did what everyone needed it to do right? You could call out and receive calls, send an SMS message, heck you could even play "Snake", who remembers that game? And this could all be done cordlessly, mind blown! Anyway I digress, but we see how phones have advanced immensely in what they offer, you can now send and receive emails etc. This is effectively what Engle did during a time where science was evolving.

When a client walks over the threshold, they are coming to present to you signs & symptoms hoping for a definitive answer. We let them present what they think to be key information, but as practitioners it is key that we dig deeper & really spend that time on gaining the true history. We are looking out for what I refer to as 'Buzz words'. These are words, that lets you get to know more about the persons mental state, and to gauge this, you really need to get them talking and posing open style questions. Whilst we are listening, we must be sure to demonstrate our active listening skills, allowing the client to feel comfortable enough to open up and really give a detailed history. Once they do this, the process of building 'trust' has begun. It is essential not to break this, as it can be hugely damaging on the recovery process for the client. When we are responding and asking our questions it is key to be mindful of the tone that we use, and the metaphors that we use as these words can be perceived negatively and again being detrimental to the clients recovery. I listened to a Podcast not so long ago, with Jo Gibson being interviewed and the topic was about the unstable shoulder. It was a really good interview and in fact, I recommend listening (before you go though, please finish reading my blog ). She mentioned that actually during this phase, you want to actually be neutral in response as it was found to make the client less dependent and improved self efficacy over a practitioner who was more empathetic. I draw back to my example I made earlier, with the identical ankle sprains. The differences may not be physical but if you strip back the layers, they are likely to be in two different places mentally, and you need to work with this, by being considerate to the fact that the words you use, hold weight and will be impactive on recovery therefore chose them carefully, so that they are supportive to your work rather than destructive.

Someone who has experienced a similar injury previously as to someone who is only experiencing their first injury will think differently. They will have different questions and they will have different fears. It is these type of factors that sets the 'identical ankle sprain' apart. So whilst we want to give the client the definitive answer and prognosis that they are hoping for rapidly, take time getting to know your client first rather than getting overwhelmed by the signs and symptoms that they are presenting to you, as doing this you might be able to reduce the symptoms for a short while, but in terms of treating the injury and reducing the chance of injury reoccurrence, well that takes more.