What To Do If Your Patient Isn’t Adhering To Your Treatment Plan

We have all had tricky patient’s. You make progress in the clinic, they go away, and next week they’re back to square one. You know they haven’t even been thinking about your treatment plan.

Where do you go from there? As a therapist you can feel powerless. This week I’ll show you just what to do if a patient is not adhering to your exercise and treatment plan…

Patient adherence was one of the biggest frustrations for me as a new grad. At times it felt impossible. Very quickly realised that it wasn’t a problem with the patient at all, but a problem caused by the therapist. It starts in the subjective assessments.

The first thing we have to do in the subjective assessment is to identify the internal motivator within the patient. The internal motivator is the thing that will cause the person to take action.

If someone comes in with back pain then they aren’t just coming because of the back pain. They have come to the clinic because that pain is having a knock-on effect in their life. If my rehab exercises are all about the back and not based on the patient and where they want to go then the chances of success are very slim.

When you focus on the patient’s story and goals then two things happen….

1. You as a therapist have clarity on the rehab programme. 
2. The patient has clarity. 

The patient will begin to understand the process that needs to happen to get to the ideal outcome.

Whether we like it or not, when a patient comes into the clinic, we are selling a transformation. We are helping them transform from where they are in pain to where they want to be and their goals.

Unless a patient can see how an exercise fits along their journey then then the adherence to the exercises will be very low. If you can relate the exercise to how it will help them on their journey then it will make sense to them on how it will help their journey.

The next time the patient isn’t adhering, reflect on what you did in the first session. How much time did you spend explaining what needs to be done to get to the final outcome? Do they have clarity on where they want to get to?

It is the same with private practice and professional sport, your patient needs to know where they need to get back to. ‘I just don’t want to be in pain’ isn’t enough. It needs to be clearer. Clear goals will get your adherence and adherence will get results.

You will not believe the transformation once you start focusing on the person, on the outcome and on peak performance. 

I cannot stress enough the importance of your subjective assessment. In the mentorship I spend a whole week teaching the subjective assessment. It is the true key to patient adherence and the first stumbling block for many therapists.

When you focus on the patient and find the internal motivator, we identify the ideal outcome and we start to extract meaningful information. Once we have all of this information, providing a step-by-step graded exposure rehab programme becomes easy.

Next time your patient is not adhering to your exercises, take a step back, reflect on the subjective assessment.

For more on the tips and advice on how to be the go-to therapist click here.