Integrating the fields of Physical Therapy and Clinical Psychology

M

myr11

Does anybody know of any PTs who are also using a clinical psych degree or sports psych degree to work one on one with patient's? I am curious if there is anyway to integrate the two disciplines. (E.g. Treating your patient's LBP with PT intervention, as well as psychotherapy). My questions would be how would the billing work? Is it considered unethical practice to refer to yourself for other services? And could you somehow use both approaches simultaneously? I am a DPT student with a psych major who is considering eventually getting a post grad psych degree. Any input appreciated! Thanks
 
Nov 3, 2010
203
0
Status
Rehab Sci Student
Can you find 5 unique examples of different patient types that could use physical therapy and clinical psychology utilized in subsequent sessions actually worthwhile?

Would you assume a person needing physical therapy inherently needs clinical psychotherapy or the like?

Otherwise, there will be people to say leave on specialty to one field and other to the other. You're best bet if you have interest in both is finding two part time jobs that are separate in each field if you want to practice both.

In the end, what substantiates 100K-125K in additional loans & 4-5 years extra time that actually adds additional worth to a DPT degree?.. Heck, you'll probably be 30 at earliest by the time you get out of both programs too.
 
OP
M

myr11

As far as 5 unique examples...After working with many patients in a PT setting, many of their emotional/psychological issues become apparent after several weeks of treatment. People are much more willing to be treated for physical pain than emotional pain or psychological issues, and I feel like these people can be helped in a similar setting since these issues can exacerbate each other and can not necessarily be treated as 2 completely separate conditions.
Yes I feel that some patients would greatly benefit from psychotherapy much more than others, but I do not feel that all patient's inherently need these services. I just happen to be very interested in both fields and believe that I would like to integrate both approaches some how. There are certain types of patients such as individuals with eating disorders who may also be athletes that I would like to work with. I am not really looking at a numbers game at this point...I am in plenty of debt and I am not 21...I am just looking to accomplish what it is I originally set out to do and to be content doing it. I am surprised nobody knows of anyone integrating these fields in any way, or a type of clinical psychology degree/certification that would be relevant to want I am looking to do.
 

DancerFutureDPT

Academic Administrator
Moderator
7+ Year Member
Jun 9, 2009
843
17
Chicago suburbs
Status
Academic Administration
Sports psych might be an interesting degree if you have it already, but I wouldn't seek it out simultaneously.

But, in PT school (at least for us) we have several courses we have to take that are devoted to psychosocial development and how to integrate that into our care....for example our psych class practical was combined with our eval practical (basically we had to do the initial exam/screens and interview of the patient)...part of what we learned was that the patient had a recent family stresser, so we had to address that as well.

But I don't think there could realistically be a PT/psychologist degree, at least not right now. Most people have some psych issues, sure, but not to the extent that they would need counseling in addition to PT.
 
OP
M

myr11

DancerFutureDPT, we also have training in the psychosocial model in our program, and I am definitely not looking for a dual degree as I am already in a DPT program...What I was looking for was a way to find a niche where I could integrate 2 different approaches, psychotherapy and physical therapy. Not all patients would benefit from this BUT those suffering from chronic illness, patient's who seem to be experiencing more psychosomatic symptoms, and those with mental health/emotional dysfunctions which manifest into physical symptoms (such as eating disorders, depression, the list goes on and on and on) could potentially benefit from an integrated approach...YES you could say treat both issues separately and to a degree you do have to treat them separately, but you have to admire our ability as a physical therapist to explore the connection between mental health and functional limitation. In our model now we can't treat someone with functional limitations unless they show measurable impairments during our evaluation. Third party payers say, we can not pay you unless there are actual physical impairments that a physical therapist will improve which could return these patient's to a prior level of functioning or a new level of functioning which their disability is holding them back from. Just think about STRESS in general...It is a CHEMICAL/PHYSICAL response! Think about the many ways a physical therapist with a clinical psychology degree could treat both the stressor and the stress itself! It could make the treatment process more efficient, effective, and less painful for many individuals...Why am I the only one who has thought about this so damn much?
 

lee9786

10+ Year Member
7+ Year Member
Feb 3, 2009
616
9
Status
Pre-Rehab Sci [General]
DancerFutureDPT, we also have training in the psychosocial model in our program, and I am definitely not looking for a dual degree as I am already in a DPT program...What I was looking for was a way to find a niche where I could integrate 2 different approaches, psychotherapy and physical therapy. Not all patients would benefit from this BUT those suffering from chronic illness, patient's who seem to be experiencing more psychosomatic symptoms, and those with mental health/emotional dysfunctions which manifest into physical symptoms (such as eating disorders, depression, the list goes on and on and on) could potentially benefit from an integrated approach...YES you could say treat both issues separately and to a degree you do have to treat them separately, but you have to admire our ability as a physical therapist to explore the connection between mental health and functional limitation. In our model now we can't treat someone with functional limitations unless they show measurable impairments during our evaluation. Third party payers say, we can not pay you unless there are actual physical impairments that a physical therapist will improve which could return these patient's to a prior level of functioning or a new level of functioning which their disability is holding them back from. Just think about STRESS in general...It is a CHEMICAL/PHYSICAL response! Think about the many ways a physical therapist with a clinical psychology degree could treat both the stressor and the stress itself! It could make the treatment process more efficient, effective, and less painful for many individuals...Why am I the only one who has thought about this so damn much?
Psychology and PT are intertwined. Especially with new pain treatments focusing on the CNS as opposed to mechanical abnormalities (at least from what I've grasped.) For those who say this is the area of chiros I laugh. Within ten years the Chiro profession will or at least should be obsolete due to PTs, and PTs will be filling the void for conservative pain management. See Lorimer Mosley, David Butlers book "Explain Pain." This should be part of the DPT curriculum.
 

Akiramay

10+ Year Member
7+ Year Member
Nov 18, 2008
374
1
Chicago
Status
Physical Therapist
Psychology and PT are intertwined. Especially with new pain treatments focusing on the CNS as opposed to mechanical abnormalities (at least from what I've grasped.) For those who say this is the area of chiros I laugh. Within ten years the Chiro profession will or at least should be obsolete due to PTs, and PTs will be filling the void for conservative pain management. See Lorimer Mosley, David Butlers book "Explain Pain." This should be part of the DPT curriculum.
We actually had a lecture in my musculoskeletal dysfunction class where my professor talked about concepts from 'Explain Pain'. We had to read a really interesting article about how cortical changes occur in people with chronic low back pain. There is a whole side where some PT's just treat patients with chronic pain and have to break through a lot of the psychological issues. They can help via mirror visual feedback, graded motor imagery, and other cognitive behavioral therapies.

Here's the article info in case you're interested:
Wand BM, et al. Cortical changes in chronic low back pain: Current state of the art and implications for clinical practice. Manual Therapy (2010).
 
May 19, 2009
133
2
Status
Rehab Sci Student
Pitt is doing some really groundbreaking stuff managing post concussion syndrome with an integrated effort from PsyD's, vestibular PT's, ortho PT's annd MD's. This group came up with the IMPACT test and is really changing the way concussions are/should be treated properly.
 
Jan 25, 2011
1
0
Status
DancerFutureDPT, we also have training in the psychosocial model in our program, and I am definitely not looking for a dual degree as I am already in a DPT program...What I was looking for was a way to find a niche where I could integrate 2 different approaches, psychotherapy and physical therapy. Not all patients would benefit from this BUT those suffering from chronic illness, patient's who seem to be experiencing more psychosomatic symptoms, and those with mental health/emotional dysfunctions which manifest into physical symptoms (such as eating disorders, depression, the list goes on and on and on) could potentially benefit from an integrated approach...YES you could say treat both issues separately and to a degree you do have to treat them separately, but you have to admire our ability as a physical therapist to explore the connection between mental health and functional limitation. In our model now we can't treat someone with functional limitations unless they show measurable impairments during our evaluation. Third party payers say, we can not pay you unless there are actual physical impairments that a physical therapist will improve which could return these patient's to a prior level of functioning or a new level of functioning which their disability is holding them back from. Just think about STRESS in general...It is a CHEMICAL/PHYSICAL response! Think about the many ways a physical therapist with a clinical psychology degree could treat both the stressor and the stress itself! It could make the treatment process more efficient, effective, and less painful for many individuals...Why am I the only one who has thought about this so damn much?
Dear myr11, I really appreciate your questions and articulation. I found it because I am wondering the same thing. I am just now trying to decide between clinical psych or DPT. DPT seemed the obvious choice for me because of my dance/movement/body work background, but because I am more interested in working with populations who are less body aware, less familiar with exercise and sports, or have more trauma and chronic illness, expertise in clinical psychology seems like it would be smart for me. I am also considering Traditional Chinese Medicine, which could tack on another 5 years of study.

One answer to your question, I've found some programs, like St. Catherine's University in Minneapolis, which offer 6 year programs --a bachelor's in psych and a DPT-- but these programs are few and far between, and are not in any city that I would actually like to spend time in for 6 years (no offense to Minneapolis). I've seen professionals with the LMSW and have then later received the massage therapy, fitness training and other bodywork-oriented certifications.

I'd still like a more thoughtful, deeper conversation from DPTs on how much psychology training they receive, use, and what else.