Hey Hey,
Have you ever had a name pop up in your diary and groaned, or died a little on the inside?
I'm sure we all have them. I've been stuck on that feeling this week.
Think — reflect
- Does it change how we show up as a clinician?
- Do I listen for less time? Do I offer less?
- And is it okay that my treatment changes depending on how much I gel with someone's personality?
- Isn't it our job as professionals to be professional, and to perform for every client no matter their circumstances?
Learn
I found this paper on therapeutic alliance in musculoskeletal care. Read it here.
The key thing that popped out for me is that these are skills we can build, even when we don't "like" the client.
Structure the first consult around agreement, not just assessment. Agreement on goals was the single most reported part of alliance at 24.6% of studies, with agreement on tasks close behind at 20.7%. So the initial consult needs a spoken step where you name their goal back to them and agree the plan, rather than prescribe it.
Train the specific behaviours, don't just talk about rapport. This is the useful bit, because it names observable behaviours instead of leaving alliance as a personality trait. You can do all of these without liking someone.
- Active listening, in 30% of studies, and clear explanation of information at 20%
- Positive feedback on how they performed the exercise. In the Sluijs study this was the one physio behaviour significantly related to compliance
- Proactive follow up between sessions
Play
This week, when a name in your diary gives you the ick, I challenge you to just be aware of it. You don't have to change how you show up.
I wonder if the awareness alone will change their outcome.
As always, let me know how you go?
Cheers
Jess
PS — oi, don't forget The Clinical Collective is free to join. Clinicians just like you, all pretending they don't have a list.