I was recently alerted to a very interesting article, written by a Swedish naprapath called Tim Husted- (no I’d never heard of naprapathy either, but it sounds a bit like what we do) – whose list and bank balance shrank following his conversion to the biopsychosocial model.  It is called When your therapeutic ideology becomes a disservice to the patient,  it I’m afraid the link has disappeared though you might be able to find it if you search hard enough, though the reader who alerted me to the broken link had a go and couldn’t.

He realised that

having a revelation in a theoretical realm … doesn’t necessarily translate into brilliant practical, permanent solutions

I suppose any fixed ideology can become limiting, but maybe pain science particularly lends itself to losing patients, because as he points out it can be understood by the patient as:

– The tools the therapist has are not that important
– I just have to move more
– Nothing is wrong in my body

Why bother with treatment then? You might just as well join a gym.

He also points out that some of the effects of learning the pain science model – realizing that your diagnosis might be uncertain, that specific techniques might not be that effective, and that the evidence base is changing all the time – can affect your confidence and the confidence that the patient has in you, undermining the entire therapeutic relationship.

By this logic presumably the practitioners making the most money have a system which tells patients “There is something seriously wrong in my body which only my therapist understands and can treat, and it needs lots  of this unique but very expensive specialized treatment.”

I’d recommend you try to find this clearly written article.  For those seeking free CPD it even includes a link to a one hour course on motivational interviewing, something which I’ve only recently heard of but is all about how you get patients to do things.