Carole B. Lewis Lecture: Management of the "Difficult" Patient

William H. Staples, PT, DPT, DHSc, FAPTA*
The purpose of physical therapy is to improve movement for function and restore individuals to the level of activity needed to work, live, and play. Mental health issues such as depression, anxiety, and fear affect the older adult. Managing pain is also a significant component of physical therapy with many tools to address pain and the perception of disability. The pain-relieving effects of many physical therapy interventions tend to be short-term and provide limited success in the long-term. Exercise, stretching, and movement may offer more lasting relief from pain and provide tools that patients can use to self-manage their symptoms. The biggest component of rehab is education about pain and instilling confidence in a person’s amazing capacity to heal. Pain is a complex multisensory and psychological experience involving sensory and affective components and can be an element involved in other mental health issues. People are able to reflect upon what they are experiencing, and physical therapists must attend to a patient’s thoughts and beliefs about their pain and other issues. Attendees will learn about evidence-based psychological approaches for pain, including acceptance and commitment therapy, and cognitive behavioral therapy, that are only discussed minimally in entry-level programs