It is great to be here with you again. In each episode, we generally discuss the impact of physical therapy treatments on the management of chronic pain and other chronic diseases. From there, we have explored other overlapping problems and conditions, such as things like opioids, the over-prescribing of opioids or addiction, and the movement to choose physical therapy as an alternative to opioid medication.
A clear movement also exists for a physical therapist to play a more pivotal role in treating and managing non-communicable diseases such as diabetes, metabolic syndrome, hypertension, and cardiovascular disease. This should not be too much of a leap because, as physical therapists, we have had a specialty in cardiopulmonary physical therapy for many decades. Something happened during the COVID-19 pandemic which changed our profession as well as changed our personal lives.
America’s mental health declined, with anywhere between 28% to 40% of adults struggling with depression during the height of the pandemic. Many of those numbers have stayed consistent. More people have been prescribed antidepressant medications and the mental health care shortage intensified with many providers in clinics having waitlists of 4 months to 1 year, which left many people without essential healthcare or mental health care services. As licensed doctoral trained healthcare professionals, we, physical therapists, whether realize it or not, see people with mental health concerns daily in almost every practice setting.
Our profession, like many others, has begun to advocate for ways to improve mental health and mental well-being. We now know that the epidemic of depression requires a supporting role by physical therapists. The reason is that the influence of physical therapy extends way beyond the physical benefit. It improves mental health and promotes mental well-being. Screening and addressing behavioral and mental health concerns are within the scope of physical therapy practice guidelines.
The American Physical Therapy Association published these guidelines in 2020 in the House of Delegates’ position statement. This position is generally in line with the best evidence and the growing trend in psychological uniform physical therapy, which incorporates bio-psycho-social treatments for chronic pain and other health conditions.
A few decades before the American Physical Therapy Association published these guidelines, there was the International Association for Physical Therapy and Mental Health, which is a sub-chapter of the World Confederation of Physical Therapy, which described the need and scope of physical therapy and mental health, behavioral health, and psychiatry.
What we are seeing is the construct of psychologically informed physical therapy is the same, similar to, or compliments mental health physical therapy, which is used to facilitate body awareness, problem-solving skills, cognitive restructuring, and ways to cope, which reinforce self-efficacy and improve quality of life in the face of poor mental health.
It would then appear inherent that a physical therapist can use biomedical treatments as well as psychosocial treatments based on their key role in reducing disability and fostering positive human growth. Occasionally, as physical therapists, we sell ourselves short and fail to understand the depth and the breadth of the impact we can have on someone’s quality of life. What I am referring to is the emotional and psychological benefits that can increase the value of care that we provide as individuals and as a profession.
Now more than ever, it is important that we understand and explain the breadth of the therapeutic benefits that we provide because studies demonstrate that approximately a quarter of all Americans may have a mental health condition. 25% to 50% of patients in a general outpatient physical therapy clinic have a mental health condition and upwards of 70% of patients with low back pain that report to physical therapy have some level of depression. We are already seeing this in practice.
There is a place for us to be primary care and entry point providers into the mental health care system. However, that does not mean that we simply “refer out.” It means that. As professionals, we stay engaged in patient care, and we continue to play a role independently or in the code management of the mild, moderate, and severe depression or other mental health conditions that exist in the populations of patients that we treat.
In fact, there is some literature that mild to moderate depression improves over the course of physical therapy, regardless of whether or not a mental health provider is engaged in the plan of care. How can that be or why is that? It is because movement, body awareness, physical activity, exercise, and many other interventions that we use as professionals are a catalyst for positive mental health and improved psychological well-being. When you combine physical activity with cognitive reappraisal, there is generally a greater impact on outcomes and the quality of life of the patients that you care for.
Joining us to discuss the role of the physical therapist in treating depression is Dr. Tony Varela. He is a physical therapist who brings many years of experience in musculoskeletal health, including pain management. His professional principles were paved through residency and fellowship, grounded and rich patient experiences, and reinforced by serving those surviving chronic pain, cancer, as well as trauma, and PTSD from war.
He believes there is a better version of ourselves ready to push through and he is an Assistant Professor at Arkansas College of Health Education. Tony authored a paper in the February 2022 edition of Physiotherapy Theory and Practice called The Theatre of Depression: A Role for Physical Therapy, which we will discuss in this episode. Without further ado, let’s begin. Let’s meet Tony and discuss the role of physical therapy in the treatment of depression.
Love the show? Subscribe, rate, review, and share!
Join the Healing Pain Podcast Community today:
Love the show? Subscribe, rate, review, and share!
Join the Healing Pain Podcast Community today:
It's great to be here with you. Thanks for joining. In this episode, we are discussing a new assessment tool to guide behavior change, which is called The Physical Therapy Healthy Lifestyle Appraisal. It was developed by Dr. MarySue Ingman, who you will meet in a couple of moments. This is the first validated assessment tool for a physical therapy practice, where we can look at nutrition, physical activity, stress, sleep, and tobacco use. What I like and appreciate about this tool is that it's quick, easy, fits well into physical therapist practice, and especially if you are using integrative or lifestyle medicine approaches to treat chronic pain or chronic disease management.
Let me share a little bit about our guest. Dr. MarySue Ingman is an Associate Professor in the Doctor of Physical Therapy Program at St. Catherine University in St. Paul, Minnesota. Her research interests include the role of a physical therapist, health promotion, and clinical practice. She's published studies on motivational interviewing and the role of physical therapists in health promotion and wellness.
In this episode, you will learn a lot about counseling, assessment, and the science of behavior change. In fact, this episode is a sneak peek into some work that all of us have been working on for years. Some of you may know that I co-edited a textbook. That textbook is called Integrative and Lifestyle Medicine in Physical Therapy. My co-editor was another physical therapist, who you might know, whose name is Dr. Ginger Garner.
In that textbook, we invited about 40 physical therapy professionals, researchers, and educators, to contribute to this book on Integrative and Lifestyle Medicine in Physical Therapy. Chapter 3 in this textbook, which is called Coaching, Counseling, and the Science of Behavior Change, was written by MarySue and her colleague, Dr. Janet Bezner, a Professor in the Department of Physical Therapy at Texas State University.
That textbook is on track to come out soon. We are excited because we think that this will be useful for physical therapy educators, as well as clinicians who are using integrative and lifestyle medicine in physical therapy. As I mentioned, Chapter 3 is written by MarySue, where we go into Coaching, Counseling, and the Science of Behavior Change, which we will discuss in this episode. Without further ado, let's begin and learn about the Physical Therapy Healthy Lifestyle Appraisal and meet Dr. MarySue Ingman.
Love the show? Subscribe, rate, review, and share!
Join the Healing Pain Podcast Community today:
Love the show? Subscribe, rate, review, and share!
Join the Healing Pain Podcast Community today: