Episode 3 - Sensitive Practice in Physiotherapy – A Primer

08/15/19 • 13 min

“ With prevalence numbers at 30-40%... physiotherapists should act under the assumption that every patient they encounter has experienced sexual abuse or sexual assault of some type.”

In this episode, Jody Prohar, Registrar and Executive Director of Physiotherapy Alberta and Leanne Loranger, Manager of Policy and Practice talk about how a history of sexual assault has the potential to affect the patient-physiotherapist relationship.

When physiotherapy assessments or interventions are clinically appropriate they do not constitute sexual abuse or sexual misconduct but, is that going to be a comfort to the physiotherapist if a patient makes a complaint because they thought the physiotherapist did something inappropriate?

Could a history of sexual assault effect how the patient perceives the physiotherapist’s actions?

Clear communication and strong consent practices are the key to avoiding misunderstandings or patient distress.

With the high prevalence of sexual assault in Canada, physiotherapists should view sensitive practice as a universal precaution. They need to know about the effects of trauma and how triggers can powerfully remind a person of a past assault causing them to re-live it.

Towards the end of the episode we highlight some things physiotherapists can do to try to avoid triggering a traumatic memory, discuss patient reactions that may indicate that a memory has been triggered and provide suggestions for where physiotherapists can go to learn more about these topics.

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“ With prevalence numbers at 30-40%... physiotherapists should act under the assumption that every patient they encounter has experienced sexual abuse or sexual assault of some type.”

Could a history of sexual assault effect how the patient perceives the physiotherapist’s actions?

Clear communication and strong consent practices are the key to avoiding misunderstandings or patient distress.

Resources:

Links:

Previous Episode

Episode 2 - The Dirty Joke

“If I tell a friend a dirty joke, it’s just me telling my friend a dirty joke. But if I do the same thing with a patient, I’m at risk of a complaint of sexual misconduct and could face a license suspension.”

In episode 1, Jody Prohar, Registrar and Executive Director of Physiotherapy Alberta and Leanne Loranger, Manager of Policy and Practice touched on behaviours that are normal in a personal relationship, but unacceptable in a physiotherapist-patient relationship.

In this episode we go into greater detail about how dirty jokes and other seemingly innocent comments could lead to big trouble for physiotherapists because of how sexual misconduct is defined by theHealth Professions Act.We discuss the concepts of professionalism, power, and power imbalance in therapeutic relationships.

Towards the end of the episode, we highlight strategies physiotherapists can use to try to share power with their patients.

Can the power imbalance between patient and physiotherapist ever be fully equalized?

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Next Episode

Episode 4 - Is it Physiotherapy?

Jody Prohar, Registrar and Executive Director of Physiotherapy Alberta and Leanne Loranger, Manager of Policy and Practice discuss emerging physiotherapy practices.

“When asked whether an activity is within the scope of practice for physiotherapists, we need to provide an answer with public interest/public protection top of mind. But it’s not always easy to settle on an answer.”

When asked about activities as diverse as cupping, shock wave and blood flow restriction, Physiotherapy Alberta reviews governing legislation and regulations, the evolution of the profession, physiotherapist education and competence, and the evidence regarding the proposed treatment.

When it comes to emerging practices, their spread and adoption will vary depending on the rules and context of different jurisdictions. Are we “falling behind” or are there factors that make a practice safe and effective in one jurisdiction, that are absent and make the same activity unsafe in Alberta?

Physiotherapy Alberta has a role to play in asking questions and staying informed about emerging practices as part of fulfilling our mandate of public protection. Similarly, physiotherapists need to ask tough questions and pause before jumping on trendy treatment approaches.

In this episode we discuss our approach to reviewing emerging practices using the Canadian Alliance of Physiotherapy Regulators “Is it Physiotherapy?” tool and encourage members to do the same.

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