1. PTHA 1301:
The Profession of Physical Therapy
FALL 2011: WEEK 9, LECTURE 1

2. QUIZ
DARIUS
GOES
WEST

3. Today’s Theme Song
Something Beautiful

4. Goals for Today:
Personality Part 2 & Motivation
 Discuss upcoming research paper/presentation
 Identify 16 personality types listed on the MBTI Self-
Scorable Form M
 Describe the effect of personality type on physical
therapy care
 Describe factors affecting motivation
 Explore the phenomenon of adherence to treatment
 Discuss the role of health care professionals in
promoting motivation and adherence

5. Research Paper Due Dates
 Rough Draft w/citations (at least 5 pages)
 due Sunday 10/30/11 at 11pm via Blackboard
 Rough Draft of Visual Presentation
 due Tuesday 11/01/11 at 2:30pm via Blackboard or in person
 Printed Draft w/your edits & at least 1 peer edit
 show Elaine 11/03/11 by 2:30pm
 Printed Final Paper (7-10 pages)
 due Tuesday 11/08/11 by 2:30pm
 FINAL Visual Presentation & Handout
 due Tuesday 11/08/11 by 2:30pm via Blackboard or hard copy
 due Tuesday 11/08/11 by 2:30pm via hard copy

6. Research Paper Requirements
 APA Format – writing style guidelines published by
The American Psychological Association
 7-10 pages (Introduction, Body, Conclusion)
 PLUS: Title Page & Works Cited (Reference Page)
 Double Spaced
 1” margins on all sides
 12 point, Times New Roman font (per APA recommendations)
 At least 5 sources cited in your paper
 One of the 5 sources must be a personal interview

7. Research Presentation Requirements
 8-10 minutes in length
 Utilize a visual aide during your presentation
 Power Point
 Flip Chart
 Prezi
 Prepare & issue a written handout for the class
 AT LEAST 1 page
 Be creative!

8. Personality – Part 2
 MBTI: Myers-Briggs Type Indicator
 Based on theory of psychological types (Carl Jung, 1920’s)
 MBTI Developed in the 1940s (Isabel Briggs Myers)
 Original Research for MBTI 1940s-1950s
 MBTI was first published in 1962
 Millions have taken the MBTI & research is ongoing
 MBTI: 16 personality types/personality preferences
 What is your type?
 What is the effect of personality type on PT care?

9. Behavior Change
Small Group Activity: Background Information
 Ted is a 45 year old construction worker who has
come to you for treatment of low back pain. This is
not his first time receiving treatment. You find that
he has been to PT, a nutritionist, and a back school
in the past. He admits that he had trouble following
through with the home programs. Ted continues to
be 50 pounds overweight and smokes a pack of
cigarettes per day. He is divorced and at the end of
the day, he likes to sit in front of the TV and “have a
few beers.”

10. Small Group Activity: Instructions
 Divide into 3 groups of 5
 Use the assigned method to attempt to change the
patient’s behavior
 Consider the pros and cons of your assigned method
 Problem solve in your group and prepare to present
in class

11. Motivation Defined
A psychological construct
that arouses an individual to
take the actions needed to
achieve a goal

12. Adherence
 Degree to which clients follow treatment
 Measured by factors such as
 Clinic attendance
 Degree of adherence
 Client self-reports
 Clinician’s assessment

13. Factors Affecting Motivation & Adherance
 Locus of Control
 Self-Efficacy
 Self-Esteem
 Social Determinants of Health

14. Locus of Control
 Julian Rotter (1960s)
 Dynamic theory based on life experiences
 Influenced by culture and family
 Internal Locus of Control: believe that they can influence what will
happen to them (increased self motivation)
 External Locus of Control: believe that what happens to them is a
result of outside influences/events
External
Internal

15. Self-Efficacy
 A phenomenon of a client’s perception of reality
 Sense of competence and ability
 Related to how successful people believe they can be in
accomplishing a task
 Self-Judging: Positive and negative perceptions influence
therapeutic outcomes
 Bandura introduced concept in 1977
 A strong sense of self-efficacy relates to increased
adherence
 Self-Efficacy is a dynamic concept, it can be improved!

16. Self-Esteem
 How people feel about themselves
 Do they accurately assess self-worth in comparison to others?
 Do they take pride in their abilities?
 Clients with strong self-esteem
 Tend to have higher motivation to be actively involved in their
care
 Believe they are in control of their own lives

17. Social Determinants of Health
 Race/ethnicity
 Literacy
 Education
 Income
 Place of residence
 Community resources
 Social support (see next slide)

18. Social Support
 Patients who are supported have
 Greater optimism
 Less depression
 Less anxiety
 Improved quality of life
 Higher self-esteem
 Greater adherence to treatment

19. Factors That Affect Clients’
Motivation and Adherence
 Locus of Control
 Self-Efficacy
 Self-Esteem
 Social Determinants of Health

20. Other Factors That Affect Clients’
Motivation and Adherence
 Psychological state
 Depression
 Anxiety
 Feelings of inferiority
 Shame
 Guilt
 Denial
 Fear

21. Other Factors That Affect Clients’
Motivation and Adherence
 Culture
 Health and health care history
 Practical concerns

22. Other Factors That Affect Clients’
Motivation and Adherence
 Health care professional
 Congruency of clinician and client goals
 Compatibility with clients’
attitudes, beliefs, values, style of self-regulation
 Level of knowledge and skill
 Ability to
 Empathize with clients’ needs
 Individualize treatment plan

23. Barriers to Effective
Motivation and Adherence
 Knowledge
 Readiness to change
 Congruence/shared goals
 Pragmatic problems
 Illness parameters
 Depression/hopelessness
 Self-efficacy
 Locus of control

24. Promoting Motivation and Adherence
 Clients tend to be motivated to strive towards goals
 That are important and relevant to them
 That they believe/hope are possible
 Clients tend to adhere to programs that are
 Not too difficult
 Not too costly
 Not too time consuming
 Are consistent with their health belief system

25. Strategies to Enhance
Motivation and Adherence
 Modifying health behaviors
 Health Belief Model
 Transtheoretical Model for Health Behavior Change (Stages of
Change)
 Motivational Interviewing

26. Strategies to Enhance
Motivation and Adherence
 Education and empowerment
 Client-centered care
 Goal setting
 Feedback and follow-up
 Peer support groups
 Functional programs
 Primary and secondary control-enhancing strategies
 Collaboration

27. Client-Related Barriers to Collaboration
 Non-adherence
 Impairments and disabilities
 Lack of interest in collaboration
 Perception that clinician has lack of time
 Uncertainty regarding success of treatment

28. Clinician-Related Barriers to Collaboration
 Inadequate knowledge about how to collaborate
 Unwillingness to relinquish/share power
 Paternalistic perspective
 Failure to consider pre-morbid lifestyle and history

29. Strategies for Improving Collaboration
 Client-centered care
 Ask clients to identify questions and problems in their own
words
 Facilitate open dialogue
 Educate clients about how to be active participants

30. Upcoming Assignments
 See handout for revised due dates of Research
Project Assignments
 Thank You letter to Christi Anderson due THIS
Thursday at 2:30pm

31. Go RANGERS!!!