Exploring physiotherapists' considerations regarding the use of psychosocial strategies in practice

To investigate what factors physiotherapists consider when deciding whether to use psychosocial strategies with their patients and what factors they consider when choosing a specific approach.

Content analysis of two open-ended questions contained within a cross-sectional survey was conducted. Australian physiotherapists (N = 201) provided written comments.

Textual data were subjected to content analysis. Two key categories emerged: practitioner considerations and patient considerations. Subcategories included physiotherapist factors, practice environment, patient biological factors, patient psychological factors, and patient social factors. When contemplating the use of psychosocial strategies, physiotherapists' responses aligned with a biopsychosocial perspective. The most common consideration overall was patient attitudes. Physiotherapists reflected on which specific psychosocial strategies they perceived were beneficial for a particular patient based on their presentation. Scope of practice was a minor factor in their decision-making process, as physiotherapists considered their knowledge, confidence, and skill base more frequently.

Physiotherapists incorporate a biopsychosocial framework in their assessment of patients with regard to potential use of psychosocial strategies. Physiotherapists displayed language that reflected a developed understanding of psychological and social issues with respect to their patients' presentation. Nonetheless, selection of psychosocial strategies was predominantly based on experience, success with an approach, perceived knowledge, skill, and confidence, as opposed to evidence-based efficacy of such strategies. These findings have implications for the training of physiotherapists. Desired outcomes are enhancing management of patients based on a biopsychosocial approach and ensuring inclusion of appropriate, relevant, and evidence-based psychosocial strategies within their accepted scope of practice.