Motivation

When I worked in acute care, I was a strong advocate for the idea that everyone deserves a chance to get therapy. I still believe that strongly, but having now worked in both home health and outpatient settings (in addition to previous placements also in skilled nursing facilities during my clinical fellowship), I've come to a new realization:

Not everyone is a good candidate for therapy.

As a new clinician, and working in such an intense setting, it didn't occur to me that not everyone responds well to therapy, and more than that, not everyone even wants therapy.

Many folks want to tell clinicians what they think they want to hear. Keep an eye on body language, and consistency with attending appointments, and motivation (or lack thereof) will become readily apparent.

See enough people do the same, and you'll get better at recognizing motivation in the moment. Part of patient-centered care is respecting when patients don't want our help.