The Scientific Method Within the Treatment Session.

Functional Therapists see new and unique cases every day. The most successful therapists continue to conduct mini-experiments and expect to see rapid results. If patients are improving within the sessions and progressing session to session we can know we're making an impact. We know it empirically... 

Definition of Empirical:

1. originating in or based on observation or experience
2. relying on experience or observation alone often without due regard for system and theory
3. capable of being verified or disproved by observation or experiment <empirical laws>

Every treatment should result in positive change. That simple standard requires that we pay attention, measure and change our approach when things aren't working.

Paying Attention

We look, feel and hear things as we're working with and helping someone. We pay attention and we remember. The observation is improved by experience. The more tools and experiences we bring to our helping relationships help us stay observant. Functional Therapy and Occupational Therapy training gives us a tremendously broad toolkit to practice from. Experiencing illness and injury through our patients gives us a unique perspective as we develop in our careers. Beyond this, experiencing illness ourselves is a powerful educator (as I can attest). All of this helps us to really focus on our patients.

Measurement

If you want to improve something it is crucial to measure it. Attention and remembering is partly a form of measurement. Finding quick ways to compare initial status to post treatment status is important if you're going to help someone improve. It also becomes important that you help your patient notice improvements. Patient compliance will increase as patients notice improvements. We have so much we can bring to people and we owe it to them to help them see the benefits. Some things may be uncomfortable but there is a tangible reason for doing what we do, the measurable benefit. We shouldn't keep this to ourselves, we want to involve our patients. Also, we must measure functional changes. I'm a big fan of the DASH, (Disabilities of the Arm, Shoulder and Hand). This measure rates the difficulties with various functional tasks.

Changing as Needed

The tremendous toolkit of skills Functional Therapy  and Occupational Therapy training I mentioned before is not only useful for helping observation, it is absolutely critical for the flexibility when we need to change things. If something is not working you need to change it. When we get into typical patterns of treatment we may miss the optimal treatment for the patient. Certain treatments are very effective in many people and often we can get close to the ideal when we deviate from the typical. There are sometimes barriers to going after the root cause of the problem but often we can find solutions that help.

In short, we need to rely on Attention, Measurement and Change to follow what we are learning empirically about the patient. Functional Therapy is an applied science. Every session is a series of experiments where the results happen very rapidly. If, as a therapist, you hold to the goal of making positive change within the session and carrying that progress through from session to session. We want our patients to get through their difficulties quickly and back to their lives and functioning.

Good luck with all your efforts to help your patients.

Yours,

Ed Kaine, OTR/L, RFT
Publisher of Functional Therapy Magazine