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Thursday, May 28, 2009

Physical Therapists' Use of Cognitive-Behavioral Therapy (CBT) for Older Adults with Chronic Pain: A Nationwide Survey

http://www.ptjournal.org/cgi/content/abstract/89/5/456

The above link is about a telephone survey of PTs from across the USA regarding their use of cognitive-behavioral therapy (CBT). This was in response to evidense in the pain management field that CBT can be effective. The PTs surveyed used CBT techniques minimally due to several factors such as lack of training and time and reimbursement issues.

My take on this: What the conventional medical model is calling CBT is simply another form of connecting the physical body to mental and emotional aspects, which when imbalanced can manifest as physical symptoms. Duh. You see, physical therapy in the USA is trying to find autonomy in the medical profession with advancements in PT education transitioning into a doctorate level and with the evidence-based mind-set (ie. "if it's not perceptible by my five senses, it doesn't exist"). With increasing "got you by the balls" tactics of health insurance companies with decreasing reimbursement for services rendered, the PT profession is being blinded by their own need for autonomy. In other words, the route they're heading for now is a route already tread by the chiropractic and medical professions where trying to establish their "worth" to insurers who care more about the bottom line rather than the actual health care of individuals is an uphill battle.

I've been using so-called CBT approaches for several years now but I never called it that. Back when I was a student right into my early years working as a PT, I had observed a direct relationship between a patient's emotional and mental status to their offending complaint. But whenever direct intervention into the mental and emotional aspects was brought up, it was deemed out of line for our profession and that area of expertise was to be referred to some kind of licensed psychiatric professional. I know what you're thinking: pretty idiotic, right? So you see why if the PT profession continues to neglect the interrelationships of the physical, emotional, mental, and dare I say the spiritual components of the human being, how limited the profession will and currently is?

I walked away from the PT profession in 2007 because I found it to be too restrictive of my nature as a healing professional. Rather than tread the same path as others before me and become frustrated, angry, depressed, and lost, I chose to create my own path in health care.

The good news from this survey is that the PT profession has an opportunity to step outside of what is traditional and explore new avenues.

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