The Patient-Therapist Interaction: A Case Study

As the patient-therapist interaction is a collaborative effort of both participants, in the above conversation the therapist used an interrogative mode to know about the severity of pain while giving the treatment (Thornborrow, 2002). The intention may be to modulate the treatment according to the response from the patient side and the answer expected would have to be yes or no on the basis of the given form of the question. But, the patient utterance was not a direct answer. Instead of that, the patient indirectly expressed his unbothered attitude towards pain by comparing his previous experience of the pain that he experienced on the day of the accident. Even though it was an indirect response from the patient side it provides sufficient
This is apparent in the line that starts from ‘pain is not at all a problem’. This motivation considered a positive act to compliance with the treatment program. This form of patient attitude is entirely opposite to the attitude that we saw in the first example (old patient’s resistance attitude). There the conflicting ideology from the patient side made a clash with the philosophy of physiotherapy. However, here in this example (Extract 6) the high motivation of the patient to take the active role in his current situation or the awareness about his own responsibilities, that creates a compatibility with the philosophy of physiotherapy.
When considering P3’s identity, P3 was a driver and the main bread earner of his family. Below quoted the PTB19 views about the relationship between pain tolerance and socioeconomic status
‘Also I felt the patients coming from low social level seems to tolerate the pain at their maximum for improvement. I think this is for getting faster improvement… then only they can go back to work’
Similarly, P3’s motivation might be considered as an extrinsic motivation aroused as a result of his external identification behavioural regulation. Identified behavioural regulation is a form of extrinsic motivation refers to a person performing an action because he or she values the benefits that will be derived (Ryan & Deci, 2000). Here, both patients were the bread earner of the family, from low SES and their identified social responsibilities made them more compliant with the treatment. PTM9 also expressed the similar opinion,
‘When considering the case of low socioeconomic family or a borderline middle-class family… usually, the men in the family were the main bread earner …and the rest of the family usually depend on that man. So such kind of patients usually seems to be highly self –motivated’. (PTM9)
According to PTM9 the life situations of the patients from low SES or borderline middle-class family might be acted as an external factor for their self- motivation. This possibly encouraged patient compliance with the treatment regimen and thereby create a positive relationship with the