Mindful Dialogues in Community-based Physiotherapy

Human relationships developed in community-based physiotherapy are usually hidden behind the walls of family homes, embedded in the practice of physiotherapists who work in those settings. In this thesis, I argue that the relationship-based approaches to practice that community-based physiotherapists foster between themselves and the people they come to help, are of utmost
importance for the promotion of wellbeing for clients.

Hermeneutic phenomenology was used as the framework for a research approach which utilised poetics, dialogue and narratives to reveal and interpret how the community based physiotherapists, clients, families and carers who participated in this study experienced and fostered their therapeutic relationships. Data was gathered via homebased interviews with individuals and families. Participants included five private practice home-visiting physiotherapists in NSW, five of their clients, families and carers (involving eight family members and five carers). Participants were encouraged to talk about their interactions and professional relationships in these therapy situations, to reveal how they interpreted the meaning of those relationships. A physiotherapists’ focus group was also held to further discuss the thematic findings arising from the interviews.
Narratives and poetry from within the experiences of the participants revealed some typical ways of understanding and ‘being together’ in these community-based physiotherapeutic relationships, which contributes to discourse about community-based physiotherapy practice. My interpretation of the research findings revealed that community-based physiotherapeutic relationships were sustained and developed by the participating physiotherapists’ attitudes and
processes of:

Being Mindful of the particular context, experience and wishes of clients,
families and the pre-understandings brought to the relationship by the physiotherapist
Staying Engaged through dialogue to maintain connection between human beings and
Being Responsive to individualise therapy for clients and enhance perceptions of identity for those
people.
A conceptual model titled Mindful Dialogical Relationships deepens understanding of
how community-based physiotherapists develop relationships with their clients, families
and carers, interweaving practice with the knowledge and experience of all stakeholders through their developing relationships. Embodiment of these processes could improve other physiotherapists’ community-based practice to address the ongoing and important issue of how practitioners, clients, families and carers relate to each other to achieve better outcomes for both parties in these therapeutic and intensely human processes of interaction.