Question
What is self-efficacy in regard to the patients/clients we serve, and how can we, as therapists assist in fostering it?
Answer
Self-efficacy is the belief that the choices/behaviors one makes impact their outcomes. That's all it is. In terms of our treatment, we can assist in fostering self-efficacy. We want our patients to put as much of the power and accompanying responsibility for their improvement into their hands. For example, if somebody believes strongly that eating a certain way will help them heal, they're much more likely to actually eat that way versus someone who's like, "Yeah, yeah, that doesn't have anything to do with it."
Increased self-efficacy decreases fear avoidance and is associated with an increased sense of well-being. Self-efficacy is one of the most powerful treatments for fear avoidance. If we can help foster this in our patients, it can help protect them from those fear-avoidant beliefs and decrease anxiety and depression. Self-efficacy is associated with exercise adherence in healthy populations and those recovering from cardiac events. It is strongly associated with therapy attendance and home program performance.
Evidence strongly suggests the following to assist in fostering self-efficacy:
- Verbal encouragement vs. passively watching
- We can verbally encourage people, "Hey, that's looking so much better than the last time you did that exercise," versus passively watching.
- Using language that resonates with that patient to facilitate positive feelings
Figuring out what language will click or make sense with our patients because the terminology that we use for things may or may not resonate with them.
- Reminding the patient of their progress, capitalizing on prior success
- Reminding the patient of their progress, those regular check-ins, "Hey, you've got this much more range of motion." "You were able to walk this much further today." Even those little tiny victories, point them out and celebrate them with your patient because that will help enhance their sense of self-efficacy.
- Sharing success stories from similar patients
- Potentially sharing, of course, de-identified success stories from other similar patients. There are other people who have successfully gotten through this, and you will too.
- Give up your own status and control, and empower your patient!
- Focusing on patient empowerment versus sort of putting your own self on a pedestal.
It has been shown that people with higher levels of self-efficacy also have much stronger provider efficacy. So if they believe in their self-efficacy, they're much more likely to believe you know what you're talking about. It will help with compliance as well.
Make sure you're prioritizing your patient's values and goals and soliciting their input into what they want those goals to be is important.
This Ask the Expert is an edited excerpt from the course 4654 Behavioral Health & Physical Therapy: What Is Our Role? by Jennifer Stone, PT, DPT, OCS, PHC
