Movement Specialists, the Biopsychosocial Model and Reflective Practice

Paul argues that physiotherapists should consider movement from the cellular to the social level, including cognitive factors such as catastrophizing, emotional factors such as anxiety and depression, protective behaviors, lifestyle, environment and socioeconomic circumstances. A guide dog example shows how reframing the model attached to a person can reduce stigma. Patients often want to know what they can and cannot do, and many have been told to stop doing things. Helping them re-engage means looking at their values and what matters to them, and accepting uncertainty, since black and white diagnosis drives overdiagnosis, overtreatment and cost. The biomedical model is not the enemy: the bio in biopsychosocial is biological. Citing Tamara Pincus, the talk warns that splitting biomedical from psychosocial can leave patients feeling disbelieved, when pain is a problem, not a psychological problem. Three questions close the part: why is this person presenting this way at this time, how can I help them get going again, and what can reduce distress and disability.