Communication strategies in psychologically informed osteopathic practice: A case report

Abstract

IntroductionThis paper presents qualitative data from communication between an osteopath and patient participating in a research study to develop a new psychologically informed pain management course. Presentation‘Adam’, aged 49, presented with persistent pain and multiple health problems including HIV and depression. His aim in joining the study was to find ways to stay independent. EvaluationExisting osteopathic evaluations of musculoskeletal dysfunction were supported by psychological assessments of health beliefs and coping strategies. InterventionPsychological and mindfulness exercises were integrated into six osteopathic treatment sessions to support symptom relief, patient learning and self-management. Data analysisAudio-recordings were analysed qualitatively using Linguistic Ethnography. OutcomesCommunication moved from ‘mechanistic’ pain discourses about diagnosis and structural damage towards ‘facilitative’ narratives involving shared sense-making about broader embodied experiences. Physical outcomes were similar to previous osteopathic treatment but with longer lasting effects due to more effective self-management, decreased fear-avoidance and increased physical activity. ConclusionThis patient reported that a psychologically informed pain management course had increased his body awareness and ability to live well despite pain. Individual case findings are not generalisable, but these data appear to support an ecological-enactive model of osteopathic practice and suggest promising directions for future research.