Response to commentary on: ‘Motivational strategies for physiotherapists’

Abstract

Radcliffe also states that physiotherapists are capable of identifying the need for interventions yet feel illequipped to provide applicable techniques and decisions are being made based on intuition and experience. To establish current knowledge levels of the theories and concepts discussed in the opinion paper, an exploratory mixed methods study has just been completed by the authors. Initial analysis is in agreement with Radcliffe’s statement; 58% of surveyed physiotherapists are aware of motivational interviewing (MI), 24% are aware of self-determination theory (SDT), 27% are aware of social cognitive theory (SCT) while 96% are aware of cognitive behavioural therapy (CBT) (n5562). Of the respondents who were familiar with each theory, only 26% reported being ‘confident’ or ‘very confident’ in their ability to apply MI, 10% for SDT, 9% for SCT, and 29% for CBT. This study also investigated how important physiotherapists feel self-efficacy, planning, empathy, outcome expectations, and autonomy are for motivation. Results show that 97% of respondents feel that self-efficacy is ‘important’ or ‘very important’, 99% for planning, 84% for empathy, 98% for outcome expectations, and 94% for autonomy and that physiotherapists feel confident in their ability to influence each of these. Radcliffe states that the challenge incorporating motivational interventions into practice is the need for practical experience. This point was also investigated in the recent study discussed previously and preliminary results indicate that lack of training, lack of experience and support, along with lack of time are the main barriers to implementing motivational interventions into practice. A second study, currently underway, will investigate this further. Physiotherapists who have completed an introductory MI course will be followed up 3 months after the completion to assess any barriers or facilitators to incorporating MI into their practice. To incorporate motivational interventions into practice, we agree with Radcliffe that there is a requirement for a structured psychological educational programme grounded with experiential learning. Previous research has shown that proficiency in promoting self-efficacy and behavioural change is not an emphasis or focus of entrylevel physiotherapy education in either clinical education or the curriculum. 8,9