Critical physiotherapy (FS-03)

Nicholls D¹, Gibson BE², Pillay M³, Setchell J⁴, Silva Guerrero AV^5
1Auckland University of Technology, Auckland, New Zealand, ²The University of Toronto, Toronto, Canada, ³University of KwaZulu-Natal, Durban, South Africa, ⁴The University of Queensland, Brisbane, Australia, ⁵Asociacion Colombiana de Fisioterapia, Bogota, Colombia

Learning objectives

1. To understand the basic tenets of critical approaches to physiotherapy and how these differ and/or add to mainstream approaches.
2. To gain knowledge in how critical perspectives have been applied to practice, education, research and policy
3. To gain insight into applying a critical perspective to participants´ own areas of professional interest

Description

Critical Physiotherapy strives to challenge and improve contemporary physiotherapy theory and practice through the exploration of views that deviate from conventional thought and practice (Gibson & Teachman 2012, Nicholls et al. 2016). It does so by examining its position on abnormality, deviance, and difference to recognize and address power asymmetries inherent in physiotherapy practice, particularly where they marginalize some groups at the expense of others (Pillay & Kathard 2015, Setchell et al. 2016). While there are variants of critical approaches, they share a common belief that medicine and physiotherapy are overly concerned with biological processes, leading to the exclusion of the moral, social, political, and cultural mediators of health and wellbeing (Nicholls & Gibson 2010, Setchell et al 2014). In this interactive symposium, we will begin with an introduction by David Nicholls to the basic tenets of critical approaches as a method of inquiry and how they can be used to interrogate any area of practice to inform and reimagine an “otherwise” physiotherapy. Each speaker will then explore an applied example of a critical approach and the implications for physiotherapy. Barbara Gibson will discuss research with parents and children that examined key ideas about disability and normality in children's physiotherapy and the consequences for young people labelled as disabled. Mershen Pillay will explore how teaching critical approaches can assist future and current rehabilitation professionals' to recognize how their practices reflect colonial origins; and how - globally - professional transformation must attend to decolonization. Jenny Setchell will draw on her research (Setchell et al. 2016) exploring (often unintentional and unrecognized) discrimination and stigma in physiotherapy. She will demonstrate how critical understandings help to highlight nuances of physiotherapy that make stigmatization and marginalisation possible in the profession. Viviana Silva Guerrero will focus on the growing influence of neoliberalism (Homedes & Ugalde 2005) on healthcare and physiotherapy. Drawing on her experience of recent changes in Colombia, she will explore how social and political forces affect professional practices and policy. An interactive session with the audience will follow. This will include facilitated opportunities for the audience members to discuss and reflect on their own experiences in physiotherapy from a critical perspective. There will also be opportunities to ask questions of the speakers. The session will conclude with summary remarks from the Chair.

Implications / Conclusions

The implications of this session for physiotherapy are far reaching. The critical approaches outlined highlight a need, and an opportunity, for rigorous reflexive enquiry into the profession. We argue that critical enquiry enables many possibilities for physiotherapy, including the ability to adapt to changing health care environments; opportunities to better integrate ethics and non-discriminatory approaches into practice; and ways to be considerate of global social and political diversity. We provide examples to highlight how to achieve criticality and the direct implications for education, policy, research and practice.

Keywords

1. critical theory
2. reflexivity
3. transformative practices

Funding acknowledgements

Barbara Gibson is supported through the Bloorview Children’s Hospital Foundation Chair in Childhood Disability Studies.

Relevance to physical therapy globally

Considering the changing and diverse nature of physiotherapy in global healthcare environments continuous reflection on the profession’s relevance and efficacy is vital. Critical physiotherapy investigates philosophical, historical, ethical and social aspects of the profession. It critiques the status quo of physiotherapy, considering and challenging assumptions and norms of practice. This symposium will examine critical approaches to physiotherapy and how they can be used to interrogate and improve research, education, policy and clinical practices.

Target audience

The session will be of greatest value to clinicians, educators, policy makers, researchers and (post)graduate students most interested in the future of physiotherapy practice.

Programme subject to change