The word “holistic” is a lot like the word “healthy” – it’s somewhat vague, but it’s assumed that the more of it you embody, the better. The current movement in medicine is toward a more holistic or integrative approach that sees the body and mind as connected and equally important for maintaining good health. And I think most of us would agree that we want our health care providers to focus on us as whole people, so the more holistic the approach, the better.
I’m excited to be a part of this movement in my occupational therapy practice. I certainly strive to provide OT evaluation and treatment in a way that views my clients as whole people. I even changed the name of my business in 2014 to include the word holistic because it better describes my current scope of services.
That being said, I actually don’t consider a holistic approach to be my primary goal when working with clients. I believe that there is a more important goal if I want to provide my clients with the most effective treatment. An experience that one of my clients recently had helps to illustrate my point.
(By the way, after close to 20 years as a therapist, I can say with confidence that my clients are some of my best teachers.)
I recently referred this client to another specialist for an issue that is not within my area of expertise. The specialist is extremely skilled and has a clinic that is conveniently located for the client. So when I followed up with the client to see how her first visit had gone, I was surprised when she told me that she wasn’t planning to return for a second visit.
When she summarized her first visit, I began to understand why she wasn’t happy. My client understood her diagnosis and had a clear idea of how she wanted to treat it. This specialist has the skill set to treat her diagnosis using traditional methods but wanted to address it from a broader, more holistic (or mind-body) perspective. I didn’t disagree with the specialist’s proposed treatment plan, but I could see why my client wasn’t satisfied.
The issue wasn’t in the holistic treatment approach to her diagnosis. It was that the treatment wasn’t client-centered.
As medical providers, we spend years being trained to evaluate and treat our clients. This puts us in a very directive role (i.e. I evaluate you and then tell you what to do to fix your health concern). And that works well in some situations. But it’s always important to consider what is meaningful to the client if we want to be most effective.
This client wanted a very traditional treatment approach for her medical condition, and by the specialist not listening to that (instead, broadening her treatment plan to include components that weren’t meaningful to the client), the client didn’t feel heard and therefore didn’t buy in to the treatment plan. She ended up finding a different specialist whose approach was more traditional, and she was very happy.
In my opinion, what it really comes down to is this: When I’m treating you as my client, it’s not about me as the provider. My approach needs to be individualized to what is meaningful to you.
For example, I believe strongly in the power of food to heal or harm the body. And the scientific body of knowledge continues to show that improving your eating habits can improve everything from your mood to your weight to the quality of your sleep to the level of inflammation in your body. But that doesn’t mean that all of my clients agree or want to focus on diet when addressing their health concerns.
So if I decide for a client that we’re going to focus on changing his or her diet as a pain management strategy (when that’s not most important to him or her), my treatment has stopped being client-centered. It might be a holistic approach, but it’s unlikely to be effective. And if a client doesn’t feel heard or included in his or her treatment, I’ve not done my job as that client’s medical provider.
I remember one of my instructors in OT school telling us how angry he was when he found out that as part of his father’s stroke rehab, the OT had him make a ceramic ashtray during a treatment session. In addition to the irony of this (since smoking is a major risk factor for stroke), his father had never smoked a day in his life. He used this as an example of why it’s always important to center treatment around what is meaningful to the client.
So should health care providers strive to treat with a holistic approach that considers the physical and emotional factors that contribute to health? Absolutely. But is that the most important thing? I don’t think so. I would argue that a client-centered approach will always be more important.
If you are struggling with health issues and want a health care provider who takes a client-centered approach to pain management, ergonomics, and/or healthy lifestyle changes, contact me – I’d be happy to find out what’s important to you and then help you meet your goals!