Therapists are ideally placed to create a collaborative self-management approach

Abstract

A biopsychosocial, patientcentred approach and good governance are central to health-care philosophy. The core of rehabilitation today focuses on the management of chronic conditions. This has enabled a shift in therapy from a conventional therapist-centred model to a patient-centred one which emphasizes managing conditions rather than curing them. In terms of patient–therapist interactions, this has necessitated a move to a concept of collaboration where goals and strategies are jointly planned and negotiated. This is more than simple adherence to treatment guidelines; it incorporates the psychological as well as the social management of living with chronic illness (Newman and Mulligan 2004). Self-management is a highly skilled approach that can only be successful in a setting that encourages self-efficacy and a decrease in stress as a management aim, thus moving from a passive to a more active treatment paradigm for the patient.