Latest / The STA Clinician Podcast / Ep.292: 'It's Not the Person: Rethinking Difficult Conversations in MSK Practice' with guest Matt Phillips

Transcript

Ep.292: 'It's Not the Person: Rethinking Difficult Conversations in MSK Practice' with guest Matt Phillips · The STA Clinician Podcast

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  You're listening to the STA Clinician Podcast, connecting clinicians across healthcare.
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  Welcome to episode 292 of the STA Clinician Podcast, formerly known as the Sports
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  Therapy Association Podcast.
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  I'm your host, Matt Phillips, and as always, this episode is being recorded
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  live on the Sports Therapy Association YouTube channel.
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  I believe there's some issues with Facebook tonight, so apologies for that.
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  We're sending out a message now for you to come over to YouTube if you want to join us live.
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  I say I'm your host, actually, for this episode, as you may have seen in the
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  advert entitled, It's Not the Person, Rethinking Difficult Conversations in MSK Practice.
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  I'm sliding over to the guest seat shortly and handing over host duties to Gary
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  Benson, who you can also see on the screen if you joined us live,
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  founder of the STA. Gary, how are you?
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  Yes, fine. Thank you, Matt. A little warm, but I've got surviving.
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  We've decided if you can hear a little fan in the background,
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  well done, tough. We'll edit that out of the podcast audio as well.
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  But if you're joining us live, you're going to have to make do because I'm in
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  Lansing, Rottie, and it's just, yeah, boiling here. And Gary,
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  you and Lincoln, which is a well-known hotspot of the world. Yeah, it's important.
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  So anyway, but before we do start with tonight's episode, thank you for having
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  joined us live, and hopefully you're making do in the heat.
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  Before we start tonight, as always, I would like to say thank you to the guests
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  from last week, particularly, I would say that, particularly last week.
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  Tim Allardyce was here, founder of Rehab My Patient. A lot of you will know Tim for doing that.
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  And he recently summited Mount Everest, all 8,848 metres of it.
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  To put that into perspective, I looked it up today, it's nearly as high as the
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  cruising altitude of a jet plane. It's about 9,000 meters there.
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  And last week, there was this moment where there's a photo of Tim on top of
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  Mount Everest on the summit at the top. But the beginning of the photo,
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  obviously, you need a photo there.
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  And he was just describing how at that point, he realized he was the highest person in the world.
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  There's no one higher than him with their feet on the ground, which is quite amazing.
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  So yeah, as you can imagine, it was an amazing inspiration episode with Tim
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  showing the highs and the challenges, massive challenges. It was amazing how
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  he personally got and how he shared his emotions and everything.
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  And the incredible grit it took to conquer the world's tallest peak.
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  And the powerful story as well behind the charity funds that he raised along the way.
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  So I would check that out. I would also check it on TikTok. I think there's
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  a link in the notes, the show notes. There's some amazing videos he's putting out there.
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  It's like watching National Geographic, but a mate of yours is actually doing
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  it. It's just wonderful.
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  I would, don't get hooked on TikTok, but definitely go over to see the videos he's showing.
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  And you can listen to the podcast as always on all popular podcast apps.
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  And the Sports Therapy Association YouTube channel.
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  And just as a final reminder, if you have joined us tonight,
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  and thank you very much, do feel free to leave questions in the comments and
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  I can bring them up on the screen. For example, people have come through it
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  already. Brian says, hi, hi, everybody.
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  Sir Glenn Murphy is here as well saying, hi, Leslie Campbell.
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  Hi, Leslie, how are you doing?
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  Is here as well saying hello in that voice exactly. And Leslie is also reporting
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  that Glasgow is not hot or even warm.
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  Sorry. Well, actually, that's nice. This is the one time you can actually sit
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  back and relax without having your feet in a bowl of water or something.
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  So anyway, if you have joined us, then feel free to jump in and ask questions.
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  It's lovely to have you along.
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  Right then. So that said and done, as I mentioned earlier, we are going to swap
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  roles, aren't we, tonight? That's the plan.
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  So what I'm going to do is I'm going to, I'm going to vacate,
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  I'm going to swap us over.
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  There's a nice visual effect now for people who are watching live,
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  you can get the seat there. I've changed my background. I'm all yours.
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  Hi, Matt. Yes. Hi, everybody. Matt, I was trying to work out earlier how long
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  we've known each other. And my best guess is around about 15 years or just over.
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  And I know we both don't look old enough for that statement to be anywhere near true.
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  So i measure it by summer i measure it by summer yeah daughter because the first
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  time i met summer she was this tiny little world she's never tiny she's your
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  daughter i remember she was like avoiding the cracks in the pavement she was
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  like i remember it was like a six,
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  six seven year old with a lovely smile and just skipping around ponytails and now,
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  yes she's married she's in the raf she just recently graduated as top from her
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  exercise rehabilitation instructor course at uh
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  stanford hall the defense rehab center yes and she will be 26 at the end of
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  this one so when you think where those 15 years gone there you go in there,
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  yeah what a great testimony to 15 years absolutely brilliant what she's doing,
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  so matt we we started this 60 plus year or 291 weeks ago really didn't we,
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  as the let's talk about you know let's keep in touch during during covid it
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  then developed into the STA podcast webinar and more recently,
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  moved over to become the STA clinician podcast so after those 291 years given
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  that you've been in the hot seat for the majority of those,
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  what's it like being on the other side of the camera.
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  It's kind of cool. It's a mixture of emotions without going on for too long.
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  Because I mean, obviously being host, as you're probably feeling now,
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  there is a responsibility with it. But especially when it's with somebody who
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  you revere somebody and I love all my guests.
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  And so often, if not always, there is a certain like, there's just a respect
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  and a thanks that they've given up the time to come on to share their massive
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  lifelong experiences and things. So there is a lot of concentration and responsibility
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  with it. So it's kind of relaxing in that way.
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  But then it's also not so relaxing, because it's kind of a vulnerability of
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  Oh, my God, what's he going to ask and what we're going to answer so it's kind of,
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  a double-edged sword but it's interesting you ask because this is this is all
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  relevant to what we're talking about like about five months ago i was on a series
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  of podcasts kind of life story podcasts probably just part of getting old people
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  are saying oh come on a life story podcast and you realize there's a reason for that
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  and it was wonderful hosted by fantastic educators i know you're aware of who've
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  been on the show like michelle lyons and ben wybrow
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  and mccauley andy thomas and and joe turner so it was a honor to be on their podcast,
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  but i was answering their questions and listening to myself and realizing how,
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  kind of unclear my whole identity and direction and focus was because most people
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  know me as the one check live guy and the get analysis guy and and i did that
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  heavily for like over a decade but for.
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  For a good few years now i haven't been or for a few years i haven't been looking
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  after runners directly a bit of consultation work online but i haven't been
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  doing get analysis so i realized that i needed to update things and that was
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  thanks to listening myself in a podcast so,
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  so yeah that's where we are today everything's kind of changed with what now
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  well not a massive change but definitely my focus means i can no longer be run chat live.
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  Well i was going to say that everybody knows you from run chat live and from
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  your online conferences and from your live edition down in brighton some years ago,
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  more recently you know all of your branding has change to Matt Phillips' education.
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  What, I know you just mentioned what prompted that change, but why the change and why now?
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  It's interesting. It was kind of that. It was realizing that every time I send
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  an email, every time I mentioned Run Check Live, I'm at from Run Check Live.
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  Because the thing about social media and websites is it is your kind of your
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  identity, unless you call yourself your name.
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  It's kind of weird. If that's not you anymore and you're calling yourself that,
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  or you're wearing the t-shirts and stuff, then it's just in your face the whole time.
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  And even my gait analysis course, I realized, which I started probably,
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  I think I was with Anna Maria and Mike Grice in maybe 2013 or something.
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  And up in Lincoln, at Lincoln University with yourself as well that was a long long time ago,
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  but I've noticed over the years how that changed from looking at the biomechanics
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  looking at the kind of running injury patterns and all that sort of stuff more
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  and more and more into the communication side of things and looking at,
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  the conversations we're having and knowing that yes we can shift load by doing
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  this and going incline or decline and changing shoes a little bit and all that but,
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  more and more the course itself was morphing into but it's how we talk to our
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  clients and it's whether the information is getting through and and it's whether
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  they're capable of doing what i'm telling them so,
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  that's been going on for quite a long time until eventually it got to the stage
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  where i had to make sure in the in the gait analysis workshops which i still
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  do in the course i have to make it quite clear that a lot of it is communication
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  based a lot of it is looking at the biomechanics but,
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  how to avoid the pitfalls of of eclipsing everything else and a lot of that
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  everything else is the communication side of things so.
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  So it's not a massive change in that sense it's not like i've totally given
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  up it's just that i've got kind of got now more of a language to describe what i do,
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  and matt phillips education definitely describes that really nicely it's more
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  that should now be future-proof for forever hopefully and it was kind of necessary
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  just to let people know yeah what i'm up to,
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  okay so you picked the title yourself today It's not the person. What do you mean by that?
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  So it's kind of, it's a lot of the work I do now, which I'm sure we'll kind
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  of talk about is, is helping people realize that a lot of the time.
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  So if you're a clinician, for example, I'm sure listeners and people who have
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  joined us live kind of have had maybe today, or they know what it's like.
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  And they say, oh, I've got such a difficult client. I've got such a,
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  they're so difficult and you don't look forward to when they're coming and nothing's
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  working and they're not doing the exercise you give them.
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  And the same thing happens, I know, from experience as I work in further education
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  that, you know, typically they're difficult students and talking to business
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  owners as well. And I'm sure people can connect to this as well.
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  Maybe you've got different difficult members of staff.
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  And what I've realized over the years and definitely with my further education
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  is a lot of the time, as soon as we call someone difficult, then we're kind
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  of making the assumption that the problem is all with them.
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  And a lot of the time that doesn't help the problem go away.
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  Either they'll stop seeing you because nothing's being solved which is not a
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  very good business model or in the process you'll get more and more irate and
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  stressed and burnt out which is a problem a lot of clinicians face so that's not an ideal so,
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  because of my history and education and looking into things and and my own personal
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  experience i realize the benefit and a lot of the work i do is explaining the
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  benefit of just pausing when you say oh they're so difficult,
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  and realizing that maybe at the end of the day communication is is relational,
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  there's always by definition at least two people involved so it's turning the
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  camera around a little bit at yourself and at your clinic whether it's a classroom,
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  or a clinic and thinking well hold on what else could be.
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  Causing this mismatch if you like where this conversation is not working because
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  there's something from both sides and when you do that when you stop kind of thinking,
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  what's wrong with this person and instead kind of start thinking what's happening
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  with this interaction then i think that can solve an awful lot of problems whether
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  you're a clinician or a teacher or a manager or boss or something
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  it just shifts the whole dynamic so that's kind of what i mean by yeah it's it's not the person,
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  one of the anecdotes on a previous podcast from dr gary mendoza.
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  About somebody attending one of his courses.
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  And I think he was a personal trainer.
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  And all the way throughout the course, he was saying, I've got this one difficult
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  client, somebody I can't get through to.
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  And Gary Mendoza was, it was the motivational interviewing course.
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  And as this person developed on the course, he was frequently asked,
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  how's it going with this difficult client?
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  Oh yeah, they're still not listening to a word I say. They're still very defensive,
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  until the end of the course.
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  Passed the course and then got in touch with Gary Mendoza and said,
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  you'll never believe it, but that client with whom I was having difficulty in
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  motivating has suddenly turned the corner.
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  And I remember you saying at the time, do you think it was the client who turned
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  the corner? Was it the trainer who turned the corner?
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  So, you know, I spoke to you previously about a difficult conversation I have,
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  and I've done a lot of reflecting on,
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  clients with whom I felt I wasn't successful and and not fully understanding
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  them and and having some really clumsy attempts in the early days,
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  of talking about pain science and and then meeting a friend,
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  of this client several years later they said oh why didn't,
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  you know natalie for the sake of her name why didn't she come back and she said
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  well because you told her it was all in her head and when i reflected on that
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  you know it was a difficult conversation i possibly hadn't understood,
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  how to communicate with this person effectively.
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  So if it wasn't the person when I was, you know, had this client in my room,
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  what should I have been looking for?
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  Yeah, that's, that's, it's great. And you've already done the first thing is
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  just pause and think what else could it be? Cause that's something which we're not taught to do.
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  So you've realized now and now, and once you realize that, I think a lot of
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  it fits into place because you start just looking at the whole interaction.
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  You think what else is going on here? Okay. If it's not in that person, what else?
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  And that means that you start looking at the environment. You start looking
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  at how that person might be feeling.
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  You start asking yourself questions like are they potentially not feeling understood
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  okay because this doesn't cross your mind because as clinicians we're taught
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  to fix fix fix and just pour out the information great information we've got but often.
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  A lot of the time we don't pause to think is this person really understanding
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  it or are they worried about something else we don't even see their facial features
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  or their their body language,
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  and this is the thing a lot of the time and this is my work in,
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  kind of working with neurodivergent individuals shows that sometimes you don't
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  get the same body language which we're normally used to when somebody is stressed
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  or somebody doesn't understand what you're saying or somebody's not able to
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  concentrate because of something in the environment,
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  so we interpret it always as resistance we think the problems with them,
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  so once you stop and take a pause and start looking at everything else in that
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  interaction that's going on from you from the environment, from the moment they
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  signed up, from their journey getting to the clinic, from how they,
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  felt when they were sitting at reception,
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  then suddenly you've got loads more things to play around with.
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  And like I say, because of my work in further education, like specializing in
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  working with neurodivergent individuals, then I see it all the time.
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  And it's probably that which has helped me kind of apply it so much to healthcare,
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  I think there's a massive crossover of communication and getting through to people.
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  And that's why, you know, like I say, we've got difficult patients and we've
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  also got difficult students and difficult staff.
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  It's actually, it's amazing once you get into it, you see people change because
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  of what you're doing, which is, which is beautiful.
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  You mentioned further education there. We've both got a history of working in further education.
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  And I left in 2013. And I do remember one student who, at the time,
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  I would have regarded as being difficult.
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  And I hadn't recognized their learning style or the way that they learned.
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  And I reached out and said, you know, what can I do differently to ensure you're
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  getting the maximum opportunity here?
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  And he said, you can take that ticking clock out of the room because that's
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  all I can focus on, you know, so, so what things about the environment.
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  Changed the way that you think about people or the, you know,
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  the people in clinical practice or with whom you're teaching?
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  I think you just nailed it. Absolutely nailed it. Cause you just asked the question.
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  This is some people think that cause we're taught that to get better,
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  we need to learn all these different skills and we need to know all these different
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  special tests and things.
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  But the biggest skill to have, and it doesn't come naturally at the time, is just ask them.
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  What would they like? How are they feeling? What could help them concentrate
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  a bit more? Is there anything you can do? And they'll give you the answer.
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  Because even if you think you know everything, and this is the thing,
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  if you try and set up the perfect clinic or the perfect classroom and you assume
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  that you are like, you know, the
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  king of inclusion and inclusivity and everything, humans are so complex.
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  You can think you've done everything. But unless you ask that question,
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  how's things? How do you feel in here?
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  Are you feeling okay? Then they'll come up with something you never even dreamed
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  of. like you said, the ticking clock.
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  And in class, because you get used to, this is like everything,
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  once you get used to asking the question, the same way as if,
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  once upon a time as a younger clinician, we get embarrassed about asking certain
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  taboo questions, whether it's to do with menstrual cycle or whether it's to
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  do with pain during sex or anything like that, then once you've asked a few times, get used to it.
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  And the same thing works when you start asking these questions and pausing before,
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  just being a bit curious.
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  So I mean, the thing that's spoilt me with,
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  not sport me that's the wrong word sport in the sense of an amazing thing which
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  gave me loads advantage was i do work with a lot of individuals in further education,
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  who are there because mainstream education has let them down because of kind of,
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  just societal norms which are placed without going into too deeply,
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  but just like not everybody can concentrate in a classroom full of 30 people
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  and with videos with no subtitles.
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  Or they're not motivated by behaviorist approaches of reward or punishment.
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  It just doesn't work. And there's loads of examples of this.
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  And it could be something as simple as black font on white paper we assume that
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  that's the norm everybody's gonna be good with that but we know and once it's
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  amazing once you ask somebody particularly new divergent learners there's a very big
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  connection between adhd for example and,
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  and what was you know commonly called kind of color blindness but,
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  the first thing we do with a with a pupil who either has been diagnosed with
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  adhd or identifies as adhd
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  or is suspected then it's just say have you ever tried color paper before and
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  and it's not every single time but it's enough of the time for that sometimes
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  particularly when they're adults just look at it and go,
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  oh my god that is just what have you done there what's this all about no one's
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  ever offered me that you know and it's just it's a beautiful thing and it spurs
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  me on and it's been incredible,
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  and also just helping people and you see it in their eyes just people who all
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  of their lives have been described as like lazy or difficult or lacking confidence.
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  And, you know, there's so many people.
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  And it's not just because they're neurodivergent, it could be other reasons
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  as well. But a lot of the case, a lot of the time it is because,
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  depending on the estimates, 20% of our population don't fit into that neuro
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  majority. And therefore, a lot of the conditions we put on in society don't work.
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  And that goes for in the clinic as well. So it's all about.
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  Changing that environment and just seeing how people who all of their lives
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  have been told they're difficult suddenly reacting in a totally different way
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  and personality changes i see are incredible sometimes and even though unfortunately
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  at the end of the day they don't,
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  like the idea of going to an exam because that's the way we test people at the
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  end of the year and we're going to put all the pressure on you and if you get
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  it right then you succeed if you get it wrong you're a failure i mean that in
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  itself is one of the classic problems of the system but at least you get to
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  the point where they get the confidence to open the book,
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  to learn a little bit, to maybe be able to watch videos with subtitles or use the colored paper.
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  And once they got that, it's very much like a kind of that pee in the snow kind
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  of thing where it gets bigger and bigger because they get that confidence. They don't feel judged.
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  Suddenly they're okay with working differently. It's not a taboo or an embarrassment
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  anymore. It's all their life. And it's a.
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  Actually I started doing when I had kids and I decided I was teaching privately
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  massage and sports therapy and once I had kids and just you know you start getting
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  a bit more altruistic and I started thinking these courses cost about seven
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  eight grand or something and I'd love to give a little bit back to people who haven't got it
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  not judging the people who have got the money that's great but I just wanted
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  to give something a little bit back so,
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  fortunately one of my clients running runner was involved in the college I work
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  at and that's how I got in there originally teaching biology and then moving into English.
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  And yeah, just opened my eyes because there's so many parallels between education and healthcare.
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  And it should be because the more we evolve as healthcare clinicians,
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  the more we realize that a lot of what we do is how we use our ears and our
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  mouth and how we kind of give people confidence and listen to them as opposed
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  to just fixing with our hands.
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  If anybody listened to the news today, there was a statistic that came out and
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  it said that Presently, there are 100,270 people who are claiming the personal independence payment,
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  and their primary disability, as it was described, was ADHD.
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  That represented between 5% and 6% of the total age group with disabilities.
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  And what we're talking about in further education now is making reasonable adjustments
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  to to ensure that each individual gets a positive learning experience that's
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  quite easy i imagine to facilitate in a clinical environment when you're one-to-one,
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  how do you manage that if you're,
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  we don't talk about class sizes of 30 in that sort of demographic aspect but
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  if you've got six or eight people all with enhanced needs or different needs,
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  how easy is that for you as a as an educator,
• 21:29
  to make a difference to each person individually.
• 21:34
  I think a lot of it, and it sounds simple, but it's not how we're brought up. It's not how society...
• 21:42
  Kind of teaches us to act, especially when we're in a position of power or authority
• 21:47
  or kind of the clinician of the white coat.
• 21:49
  It's just asking people, there's a few things. First of all,
• 21:53
  you've got to have a curiosity and it's got to look genuine.
• 21:57
  Okay. So a lot of the time you go in these courses and they teach you to ask
• 22:00
  open-ended questions and kind of make sure you've got body conduct and change your position.
• 22:04
  And so you're mirroring them. And there's all these kind of little shortcut
• 22:07
  tricks, which are supposed to work. But I think we know as human beings that
• 22:12
  We know when somebody is actually listening and not judging and actually want to be there.
• 22:18
  Okay, it's not really something you might, as a clinician or teacher,
• 22:22
  you might be faking it a little bit for the first two minutes.
• 22:24
  But if you really believe in it, and if you're a professional whose identity
• 22:29
  is that, that's who you want to be, then you soon just go into it.
• 22:33
  And suddenly you really are genuinely interested in that person.
• 22:36
  And you're genuinely actively listening. and it's not that you're trying to
• 22:40
  remember and then repeating what they said back to them in a different way i
• 22:44
  mean that is a technique well not a technique that's an approach which we learn
• 22:46
  in motivational interviewing but it's
• 22:48
  it eventually needs to come naturally because if that other person maybe for
• 22:52
  the first time in their life is with you in a clinic
• 22:55
  or or a classroom and they really feel that you aren't judging them.
• 22:59
  That you are generally want to listen to them and they can see and hear that
• 23:04
  you're listening them it's such a powerful thing and i think this is this is
• 23:08
  a classic example, it's going to be extra powerful for somebody,
• 23:12
  not just neurodivergent, but it could be somebody who's disabled physically.
• 23:15
  It could be a woman. It could be an old person. It could be anybody who no longer is in the majority.
• 23:23
  And this is why what I'm talking about and what I love about the courses is,
• 23:27
  although a lot of the focus because of personal situations and experience is
• 23:31
  on neurodiversity and neurodivergent individuals, it's.
• 23:35
  I think this applies to everybody. And this is the idea of a modern teaching
• 23:40
  thing. I'm reading a great book by Dr. Gemma Williams at the moment,
• 23:44
  and it's talking about universal design, which I wasn't actually aware of.
• 23:48
  It was started with a great architect who suddenly thought from the United States
• 23:53
  and North Carolina, I wanted a universal design. I think I've got the word right. I only read it today.
• 23:59
  Yeah, universal design on buildings. And that's where, along with a social model
• 24:02
  disability, we started thinking we need to make doors wider.
• 24:05
  We need to have ramps, we need to have dropped curbs, you know,
• 24:07
  all these sort of things which came out of physical stability.
• 24:10
  And eventually that happened. And now people have got access and suddenly you're
• 24:14
  not as disabled by society as before.
• 24:16
  But this is where, this is what excites me about the kind of the eyes now on
• 24:22
  neurodiversity and neurodivergence, because these things will become a norm
• 24:28
  like the dropped curb and the wider door.
• 24:30
  Eventually all teachers and all clinicians will realize that,
• 24:34
  you have to take into account that somebody might need more support in getting
• 24:38
  to your clinic or they might need a quieter room once they get there they might
• 24:41
  need more predictability they might need the information given to them in a
• 24:45
  slightly different way than you're used to
• 24:47
  okay they might need reassurance by you checking more than you might feel is
• 24:51
  normal or natural whether they understand and and and show care and show non-judgment
• 24:56
  so the idea is eventually.
• 24:59
  And I'm applying this very much in further education, is it's a universal design
• 25:05
  for learning as well, where it's not that you're trying to spot people who need help.
• 25:09
  It's just your approach for everything, the way you set up everything,
• 25:12
  it could be a clinic or a classroom, it's all, it's there for everybody.
• 25:18
  And that takes quite a big twist on what we normally do, just because of history
• 25:23
  and society and kind of the world we live in.
• 25:26
  So, yeah, sorry, I've blurbed on there for ages, but I think there was an answer
• 25:29
  to your question there somewhere.
• 25:30
  Yeah, and it's interesting, really, when we make these reasonable adjustments,
• 25:35
  you know, the quiet space, you know, enhanced signage and directions to the clinic.
• 25:40
  Is it as simple, because we don't know the person when they book in initially,
• 25:45
  you know, is it as simple as having a tick box on your online consultation?
• 25:51
  Do you identify as being neurodiverse? us.
• 25:55
  Can we do that and then do we then does that give us the the information we
• 26:00
  need to start making more reasonable adjustments to that client that's a really
• 26:04
  good question and i think,
• 26:07
  i like the idea that people want to include that as a tick box because that's
• 26:11
  great the same way as as other things need to pay on tick boxes just to remind
• 26:16
  us to ask a woman for example if we're treating a female athlete that we don't,
• 26:22
  make the wrong assumptions or gloss over things because we just think they're
• 26:26
  a little man and a little bit weaker and smaller so we're already aware of that
• 26:29
  the titboxes can really help,
• 26:31
  but ultimately i think that may be for some people the way to do it initially but i think the end goal
• 26:39
  needs to be to reflect and think, right, I'm not going to wait for someone to
• 26:44
  tell me that they are neurodivergent or I'm not going to wait for somebody to
• 26:49
  show me these characteristics that I suspect they might be.
• 26:51
  Because there's a lot of people who are diagnosed. They may well tell you that
• 26:54
  if you ask them. There's a lot of people who aren't diagnosed for multiple reasons.
• 26:58
  They might not have access to it. There's huge waiting lists.
• 27:01
  A lot of people haven't got the type of life or support in order to get that diagnosis done.
• 27:06
  And it can take years, even in this country where you've got the right to choose.
• 27:10
  So I think the bigger picture and what I try and be part of as an advocate is
• 27:16
  to just make tweaks in your clinic, which will automatically.
• 27:21
  Allow or increase access to everybody and it doesn't have to they're only small
• 27:25
  little tweaks to be amazed that we talk about this on the course and things
• 27:28
  just to set it up and what you say is totally right it's not just when they come in the clinic room
• 27:33
  because for a lot of people it's it's the information they got from your website
• 27:37
  were they able to get it from your website it's the conversation they had with
• 27:40
  the receptionist or maybe the automated ai thing which kind of makes me shiver
• 27:44
  a little bit because a lot of people
• 27:45
  you don't have to be neurodivergent i think a lot of people just don't feel
• 27:48
  that human connection and don't like it,
• 27:50
  okay and they might arrive already a bit irritated and a bit like i i haven't
• 27:54
  been listened to by a robot why am i gonna be listened to by you for example
• 27:57
  so there's an awful lot we can
• 27:59
  put in place before they come through that clinic door to make them feel
• 28:04
  less kind of hostile or more less kind of resistant or less trusted,
• 28:09
  so yeah i think i think it's not a case just waiting for them and doing a tick
• 28:13
  box it's looking at what you could do just to make it accessible for everybody,
• 28:19
  assuming we've adjusted our environment okay is it a potential barrier,
• 28:25
  a lot of people like myself were very reliant on a paper diary and a message
• 28:29
  facility to book an appointment but now we've got a plethora of of online booking
• 28:35
  platforms that that take away that personal element and.
• 28:40
  Is that a barrier to somebody from the neurodiverse community to actually booking
• 28:46
  and was in the first place? Do we have to make changes to our booking systems
• 28:50
  to accommodate their enhanced needs?
• 28:52
  Give me the exact, sorry, I was, I'm a great host, but I'm not a great guest
• 28:56
  because my mind just wandered off somewhere else completely.
• 28:59
  But what was the example you said using paper or something or?
• 29:02
  Yeah. So when, when I was in clinical practice, if anybody wanted to book in
• 29:06
  with me, they had to phone me up, leave a message or send a text.
• 29:09
  And i would put i would reply and i'd put them in my paper diary now we've moved
• 29:14
  away from that and a lot of people manage their clinic diaries with an online platform,
• 29:21
  how do we make sure that the online platform it doesn't become a barrier to
• 29:26
  people booking in the first place,
• 29:28
  because we're not usually in control of you know that i'll mention some rehab
• 29:32
  guru or jnap or clinico we're not in control of their processes so how do we
• 29:39
  ensure that we're not missing out on on those clients booking with us.
• 29:44
  Yeah, that's a really good question. I mean, with the online apps and processes
• 29:50
  of getting people to sign up, I'm thinking,
• 29:53
  when you look into it, there's a lot of ways that websites can be improved with
• 29:58
  regards to the amount of information on the screen and with regards to the color
• 30:02
  being used, with regards to maybe,
• 30:06
  font covering images that can often be a problem.
• 30:09
  And again it's not just for neurodivergent individuals because one day we're
• 30:13
  not we're going to stop saying neurodivergent individuals we're just going to
• 30:15
  realize that everyone's kind of got lots of different traits and and that's
• 30:18
  the way we're going to cater for everybody but but there are typical traits which make,
• 30:24
  life normal for like i say probably 20 percent of the population because it's
• 30:28
  fine for the majority but for other people it's looking at a screen and just
• 30:32
  losing it and and you might manage to muddle your way around
• 30:36
  but you might not you might not press that button, you might make a mistake.
• 30:40
  So there is kind of some 101 ways to make your website accommodating for people
• 30:46
  who don't fit into the kind of majority.
• 30:49
  But I think also it's just remembering that for some people,
• 30:55
  in order to have that predictability and that support, it's just having the
• 30:59
  options maybe of getting support from a human being, having that phone number.
• 31:04
  And I know that makes people think, that's not the idea. I just want them to
• 31:06
  click and join and not have to bother me. Otherwise, I can't be on the phone to everyone.
• 31:12
  But sometimes it's just putting it there and it's knowing that some people might
• 31:17
  use it. And when they do call, it's about not thinking, oh, I've got a difficult person.
• 31:23
  It's about thinking, right, this person's obviously not in a good environment
• 31:28
  when they're dealing with the websites and now I'm going to act inclusively
• 31:32
  and I'm going to give them that conversation, that time without judging them. So...
• 31:38
  Yeah, I've become more aware of this because we obviously have an annual CPD
• 31:42
  posse and I get regular messages and phone calls saying I'm really finding it
• 31:48
  difficult to fill in your form.
• 31:50
  So we've developed a simple form, a one page form.
• 31:54
  But now we've said, look, if you want to write it out in a notebook,
• 31:57
  get somebody to take a screenshot of it and send it in to me.
• 32:00
  I will do what's necessary to put it into your Dropbox folder and that will
• 32:04
  satisfy your CPD obligation. So I think there's a difference sometimes between
• 32:11
  a business model and a support model.
• 32:14
  And I like to think that the STA has a support model where we do recognize people have differing needs.
• 32:20
  So going back to the focus then,
• 32:24
  this idea of looking at the environment rather than trying to change the person
• 32:28
  is something that you're speaking about at the therapy show this year how did that come about,
• 32:35
  i'll get to that i just want that you you your comment just made me remind me
• 32:39
  of something we had some people on the show some people this terrible guest.
• 32:44
  Sarah Mihag and Rosie Sexton, who have just started NeuroFlect UK,
• 32:48
  they've produced, and we talked to them a while back, they've produced a reflective
• 32:53
  CPD journal, which I would definitely recommend people check out.
• 32:58
  Sarah's doing some talks, free talks about it.
• 33:01
  But that has got exactly what we're talking about. It's designed for somebody
• 33:05
  who is interested in being more inclusive.
• 33:07
  Again, it's not just going to help looking after neurodiversion clients,
• 33:10
  It's going to help looking after anybody who doesn't necessarily fit into that
• 33:13
  neo-majority kind of thing, which includes, yeah, so many people in society.
• 33:18
  And it's got tips of, and again, non-threatening kind of advice where it's fine that you don't do this.
• 33:26
  It doesn't come natural. So yeah, I'd recommend that. It probably puts into
• 33:29
  words, literally, a lot more information than I could concisely give now.
• 33:34
  So yeah, people should watch that episode. We'll make sure it goes in the show
• 33:36
  notes. It's got some great tips. So sorry, I just thought I'd mention that.
• 33:39
  Yeah, that's fine. We had Rosie. Rosie gave a talk at Mike Grice's conference
• 33:45
  in Ludlow late last month. So, yeah, I've known Rosie for equally a single amount of time for you.
• 33:51
  Actually it was me i think who asked you back years ago i said oh i didn't realize
• 33:55
  rosie sexton studied here do you think she'll be out for chat i think it was
• 33:59
  you or somebody who just said believe me you will never have a problem with rosie having a chat,
• 34:04
  and you were right and i met up with her like i think you know the week after
• 34:07
  and had about a four hour sit down with rosie yeah.
• 34:11
  And now i know why now i understand why we both so freely talk to each other
• 34:14
  for four hours but that was a really classic example of two people who are autistic
• 34:17
  i'm autistic rosie's autistic.
• 34:19
  And, and it was a great example of this kind of, this, this communication thing
• 34:25
  is, is, for example, you get somebody who is regarded as neurotypical.
• 34:30
  Okay. And so they're used to just operating in society and everything's kind of made for them.
• 34:34
  And then you try and have a conversation. They have a try and have a conversation
• 34:37
  with somebody, for example, who's autistic.
• 34:39
  And there's so many differences and expectations and ways of understanding and
• 34:43
  talking and feeling that,
• 34:45
  It just, it goes wrong. And that's, there's something called the double empathy,
• 34:49
  problem by Damian Milton.
• 34:50
  And that's where it kind of draws attention to the fact that when you do get,
• 34:54
  for example, an autistic person and a neuro majority person having a chat,
• 34:58
  it's, there's problems on both sides. It's a mismatch between two different neurotypes.
• 35:02
  But whereas traditionally autistic people were seen as being really unchattly
• 35:06
  and kind of they were said they had no empathy at all and they weren't interested in human beings.
• 35:10
  And that was how it all started off kind of thing before some wonderful people,
• 35:14
  before the internet saved it by allowing autistic people to say, hold on, I love a chat.
• 35:18
  But me and Rosie, I always look back fondly because it was two people who at
• 35:21
  the time actually didn't, we had no diagnosis, we were both late diagnosis patients.
• 35:26
  We talked for four hours and had no idea of thirst or hunger or anything.
• 35:30
  It was like when the lights started going down, we thought, I've got to get my train.
• 35:34
  But that was a classic example of somebody who, I mean, I know for myself and
• 35:38
  I imagine, I think Rosie as well would agree that put with the wrong person, maybe.
• 35:43
  Maybe with a neurotypical person on your majority who is not on the same wavelength
• 35:48
  and you do naturally just feel this mismatch and you can't talk.
• 35:51
  And it just, you've come across as clumsy and you just shut down and you look
• 35:55
  like you're not interested and your eyes start looking elsewhere and that sort
• 35:58
  of stuff and you kind of fulfill the stereotype of an autistic person so,
• 36:02
  yeah i'm glad you brought up rosie because it's exactly what i'm talking about
• 36:05
  here we need to realize that the person in front of us whether they're neurodivergent or not,
• 36:10
  may have a different way of processing things of of needing things explained
• 36:15
  that's what's all about anyway i'm blabbing on in true fashion yes therapy show sorry,
• 36:20
  will you be weaving that kind of information into your talk at the therapy show in november this year
• 36:26
  definitely yeah i'm very excited about that we've been working really i mean
• 36:29
  the sda has been working with therapy show since it started and has been there
• 36:33
  since the first year i think you were there weren't you in 2013 in manchester
• 36:36
  i joined in 2014 and we've been there ever since so
• 36:39
  this year we're working very closely with them,
• 36:42
  myself and rosie and sarah and james duahaggart who are all from the face neurodivergent
• 36:47
  msk clinician facebook group we're working closely with them to try it's a hard
• 36:51
  task we're trying to make it at least a little bit more neuroaffirmative,
• 36:55
  in the setup, which is,
• 36:57
  I mean, very challenging considering
• 36:58
  we've got 3,000-plus people flocking through the doors of the NEC.
• 37:03
  What can we do to be a little bit more inclusive? But there's things we can
• 37:07
  do. There's things which will make people...
• 37:11
  Again, I don't want to say this 20% as if it's gospel.
• 37:15
  It varies a lot and it might even be more. But if you imagine out of 3,000 people,
• 37:19
  20% of that needs someone who can do maths, but that's kind of,
• 37:23
  you can work that out while I'm talking. But that's a big chunk of people who
• 37:25
  potentially could be going through those doors.
• 37:27
  And I think a lot of neurodivergent people are actually attracted to healthcare
• 37:30
  because maybe they just find it fulfilling in terms of healthcare and looking
• 37:35
  after people and kind of maybe it's the silence being able to,
• 37:39
  I don't or whatever it is.
• 37:39
  But I find a lot of my colleagues are also kind of neurodivergent and they're
• 37:44
  in the same industry. So maybe it's that. But yeah, we're doing a lot at Therapy
• 37:48
  Show this year to try and do that. And part of that is a couple of talks.
• 37:53
  And as you mentioned here, one that I am giving, I think actually just for the
• 37:57
  people who do like images on the screen, I know the YouTube viewers do like it.
• 38:03
  There we go there is changing the room not the person so very much fits in what
• 38:09
  we're talking about tonight neurodiversity and msk clinical practice i'm giving
• 38:13
  a presentation on that which i'm very excited about that's going to talk about,
• 38:18
  a lot of what we've been doing now and again although it's kind of focusing on neurodiversity,
• 38:24
  and neurodivergent individuals it still changes which will help everybody which
• 38:30
  will help a lot of people it just make turn into a person who just considers
• 38:33
  everyone instead of just,
• 38:35
  being rigid on the societal norms which we kind of grew up with,
• 38:38
  but as well as me delivering that but which was at let's have a look i can't
• 38:43
  actually see what time that was i think that's on day two isn't it 10 yeah day
• 38:48
  two 10 30 yeah as well as that also they've given us space to do a,
• 38:54
  panel which again was with rosie and sarah mehog and james duah we're going
• 39:00
  to do a panel discussion called Beyond Awareness, Neuroaffirmative Practice, MSK Care.
• 39:05
  Again, that'll cover a lot of what we're talking about today.
• 39:07
  And I do encourage people if they are listening, I get it that people are probably,
• 39:13
  tired of hearing about neurodiversity. And I get it the same way as people were
• 39:17
  tired about hearing about gays and pride.
• 39:20
  And at one point, people were tired about left-handed people and thought they
• 39:23
  were all freaks and forced them to become right-handed in schools.
• 39:26
  It's a natural reaction.
• 39:29
  And just as now things have changed after the explosion, now left-handed people
• 39:33
  get left-handed strong guitars and they get left-handed scissors and they're
• 39:37
  not judged and they're allowed to write like they want to at school.
• 39:39
  So we do get over the natural diversity we see. Biodiversity is there for a reason.
• 39:46
  In fact, it may even be the secret success of our species, having people with
• 39:50
  different kinds of strengths and skills if you do need to do something left-handed
• 39:54
  because your right hand has just been left.
• 39:55
  You know, it's like, obviously you can imagine a situation that would help.
• 39:59
  And the same thing goes for disability.
• 40:01
  And we're reaching that point now where we're realizing that as well as biodiversity,
• 40:05
  and we've also got neurodiversity.
• 40:08
  So I'm really happy to be working in it. And I'm really pleased that therapy
• 40:11
  show giving us a platform to talk about it. And I really hope that maybe people
• 40:15
  who know me and people who know Rosie and realize that we're not kind of like
• 40:19
  too freaky and just come along and listen. And.
• 40:24
  If you're in an industry where you want to help people for not that much money,
• 40:28
  which essentially is pretty much everyone I think I'm talking to now,
• 40:32
  then you have got an altruism and you deserve to be using a model which is going
• 40:37
  to allow you to help people get success and not get burnt out.
• 40:40
  So I really think that if you kind of show interest and turn up to a couple
• 40:45
  of these, then it'll help you as a clinician and it'll help you in all walks
• 40:48
  of life in relationships and everything, because it's just about celebrating differences,
• 40:53
  and not turning them into defects.
• 40:56
  Yeah, I think it was very interesting a few years ago when we didn't have the
• 41:00
  curtains around the theatre at the therapy expo as it was then and there was
• 41:04
  the introduction of the headphones and i'm surprised how much,
• 41:08
  positive feedback was received from people who said it just shut out all of the noise from,
• 41:15
  that could have potentially interfered with with the enjoyment of the session
• 41:19
  just by having the enclosed ear space rather than being in a in a sort of a
• 41:24
  group format but those those 600 people who you reference,
• 41:28
  from the neurodiverse community who are going,
• 41:31
  to the therapy show, let's hope that they're well catered for them.
• 41:35
  Thank you for doing the maths. Thanks for the maths. That's not my story.
• 41:39
  I worked out straight away. I didn't want to jump in. So let's hypothesize then.
• 41:44
  We've got a client in our clinic or a student in our classroom and the conversation isn't going well.
• 41:53
  We've worked that out. And the tendency might to be just to give more and more
• 41:58
  information. And Mike James was an advocate of don't give 10 exercises when
• 42:02
  you can give two really good ones.
• 42:04
  You know, so how do we change what we're doing?
• 42:08
  Rather than just give information and is it as simple as as gary mendoza said
• 42:12
  sometimes they just need a damn good listening to,
• 42:16
  i met out with gary recently in cardiff he's doing very well and it was it's
• 42:19
  lovely to meet him in a motivational interviewing a couple of days we had in
• 42:23
  cardiff i mean he was great he introduced me to mi so it's i mean there's a
• 42:26
  lot in that saying some people need a good listening to,
• 42:29
  it's really it's it's really interesting i.
• 42:34
  I want to start off by saying that it's not just another modality,
• 42:39
  which has got a recipe and a list of things to do and that leads to success.
• 42:43
  I think that's really important.
• 42:44
  And it's like MI, for example, I had the honor of meeting Stephen Wolnick,
• 42:48
  who's one of the co-founders of MI, and it just brought it all back to me about
• 42:52
  how MI is not a technique.
• 42:53
  And it's so important to remember that it's just an approach.
• 42:57
  It's a way of being. It's a mindset, which I think can be so healthy for the
• 43:02
  clinician and the and the patient or client but it's like.
• 43:08
  Yeah it's it's like i said before it's it's it's not necessarily difficult,
• 43:14
  in the sense of what you've got to do but it is a definitely a shift in a way
• 43:18
  of thinking and a lot of the forces in healthcare particularly like i said like we said before we are,
• 43:23
  we are taught and kind of molded into being these operators like Diane Jacobs
• 43:29
  and Jason Silvernell said in their paper, we're fixers.
• 43:32
  And it's all very well saying we need to be facilitators, but that goes against the grain so much.
• 43:37
  And like you said, if we are in a difficult conversation and it's not going
• 43:41
  well, our default is kind of thinking we need to give them more information.
• 43:45
  And guess what? We got so much information because all the CPD we do a lot of
• 43:49
  the time, depending what you choose, it's just giving you more information.
• 43:52
  So we are walking encyclopedias and we're dying to get that out because our
• 43:56
  identity is an information giver.
• 43:58
  And that's not really that's not what we're supposed to be doing it's great
• 44:01
  to have that information but we need to be much better
• 44:04
  at not just listening but also just being aware like i say of the environment
• 44:09
  and the whole interaction and taking everything into account and you know a
• 44:13
  lot of the guests we've had like matt lowe we had on and dave newell from health
• 44:17
  sciences university we're,
• 44:19
  they're all kind of touching on this now about the importance of context and the.
• 44:27
  Even Greg Lehman was talking about this years ago, the ecosystem,
• 44:31
  he called it back then, of our clients. We need to be aware of that before we
• 44:35
  start giving them like two sets or 10 sets.
• 44:39
  And it goes against the grain because I can guarantee, and I can't guarantee,
• 44:42
  but a lot of the courses we do are still telling us, hand out this, do this.
• 44:45
  If this hurts, do this, blah, blah, blah, blah. We've got to stop doing that.
• 44:49
  We've got to start off by making sure the client feels listened to and non-judged.
• 44:56
  And we can't gloss over that. A lot of clients because of previous experiences
• 44:59
  or because of their lives, they won't trust us. And if they don't trust us,
• 45:03
  then they're not going to feel listened to and they're not going to feel understood.
• 45:06
  And we may as well be talking to a wall half the time because we can tell them
• 45:09
  to do something, but they're just going to take it as another warder from somebody who doesn't care.
• 45:13
  And this isn't just the difficult patient. I think most human beings are like
• 45:17
  this, especially when they come to see us.
• 45:19
  They're not happy. They're in pain a lot of the time, you know,
• 45:22
  and they're giving money to us and they probably don't want to give money to
• 45:25
  us some of them don't mind it but a lot of them are already arriving to us with this sense of
• 45:29
  i can't believe i'm injured again the last time i saw a physio or a sports therapist
• 45:34
  or a chiropractor i thought it'd been solved i felt great for three weeks and
• 45:37
  now i'm back here again so we've got to be aware that the human being in front
• 45:41
  of us is not in a good place
• 45:42
  so giving out information straight away is just not going to help,
• 45:46
  so we've got to look at this this interaction we've got to look at this relational
• 45:50
  thing going on and make slight tweaks to that.
• 45:53
  I think there's been, for far too long, there's been an emphasis on providing
• 45:56
  a solution for people. We can give them guidance and support.
• 46:01
  In some ways, they have to find their own solution.
• 46:05
  We can support that, but we are not magic hands. We're not fixers.
• 46:12
  So I had the privilege, Matt, last year of listening to your somewhat shortened
• 46:16
  talk at Anna Maria's conference in Exmouth, where the previous speaker,
• 46:22
  stole quite a bit of your information, if I remember, and you were talking about
• 46:26
  communication and behavior change.
• 46:29
  Did you create that course, you know, to be of assistance to clinicians,
• 46:37
  practitioners to develop these skills?
• 46:40
  Yeah, definitely. Like I say, it was born out of the gait analysis for a modern
• 46:46
  approach course, which I'm still kind of running, but it will eventually roll
• 46:49
  up because so much of my focus now is on the communication side of things.
• 46:55
  It's in everything I do. So yeah, it's, it's, again, I have to warn people in
• 47:01
  the description that it's probably not what they're expecting.
• 47:04
  It's not going to be, it's not another course where you're given a list the
• 47:07
  techniques to practice role play it boom there just use this you'll be fine
• 47:12
  because if that was what it was about you could just download the video and
• 47:14
  read the pdf and you'd be done,
• 47:16
  i mean there's a reason why day one starts off going back to 3 000 years bc
• 47:21
  with with socrates and aristotle and it sounds like what the hell is all that
• 47:25
  about but a lot of what we're talking about i think to really appreciate it
• 47:29
  and understand and get it,
• 47:32
  to allow that shift in thinking to happen.
• 47:35
  I take people on a bit of a journey for the first of the three sessions.
• 47:39
  And I do take them back to Socrates. And we look at Socratic humility because
• 47:43
  it's so interesting that back then, okay, there's a lot of things which
• 47:46
  weren't so cool in ancient Greece, but in the ways of thinking and the ways
• 47:51
  of looking at disability or different ways of thinking, there are far more on
• 47:55
  the ball than we've been since the industrial revolution, since kind of everything
• 47:59
  became about performance, performance, how much can you make?
• 48:01
  How much can you make me? We've kind Kind of, humans changed a lot when machinery started.
• 48:06
  And if we look back, then we see that our way of being and our norms were very different.
• 48:11
  So the course takes us through that and it tries to look at how humans used
• 48:16
  to be before kind of the Industrial Revolution, which is a long span.
• 48:19
  And we go through kind of the progression through evolution.
• 48:23
  Obviously it's only three sessions for like four hours or something so we have
• 48:27
  to we can't stop too many times starting with socrates but we'll go through
• 48:30
  people like descartes and obviously we get to freud and we look at
• 48:33
  behaviorism we look at skinner and then we move on to carl rogers and then eventually
• 48:38
  get to motivational interviewing and we stop for a while and talk about other kind of ways
• 48:42
  of communication and behavior change but it's only once we've been through that
• 48:47
  journey that i think what i try and do is get people to think oh wow
• 48:51
  people be doing this for a while. I get it now. I get it. I get it. I get it.
• 48:54
  And then on the second session, we start looking at some techniques because
• 48:58
  I think it's really important if you are going to be able to make these shifts,
• 49:02
  if you are going to be able to sit down with somebody and truly,
• 49:06
  make them feel unjudged and truly make them feel understood and show a genuine curiosity,
• 49:13
  there's a few little things we need to shift.
• 49:15
  We need to take off our clinician coat and step down from our box of authority
• 49:20
  and ability and actually get down to their level and as they say in mi we got
• 49:24
  to learn to kind of walk with them
• 49:26
  rather than push them into a certain place and that's what the course is all about and so far,
• 49:30
  we've got another one booked for february 2027 i'm not doing them too often
• 49:35
  because it's something which is so evolving with with my own research and my
• 49:39
  own kind of studies so but we've got another one coming up and i'd love it to be in person but again.
• 49:45
  Because it's a sign of the times it's much more inclusive these days sadly for
• 49:49
  people to be able to do it online and also from a point of just,
• 49:54
  being able to charge for it it means that if i haven't got to go anywhere that
• 49:57
  makes it far more accessible to people so hopefully one day when we all realize
• 50:00
  that we've lost so much by just doing online stuff then we'll meet up in person
• 50:05
  again and people realize that,
• 50:07
  my course needs to cover the instructor's fees for the train and the accommodation
• 50:11
  if he's going to go all the way across to the other end of the country But yeah, it's cool.
• 50:15
  Everyone who's been on it so far has kind of gone through the journey that I wanted.
• 50:19
  And it's on my website if people are interested, on mattphillips.education.
• 50:24
  For those who listen to the news this morning professor brian cox was on there
• 50:28
  and he's doing a tour at the moment three hours of information about physics
• 50:34
  and space travel and the black hole.
• 50:36
  And the universe and and he's he opens his his,
• 50:40
  uh talk with you know if you want the answers you know please go back to a reception
• 50:44
  and get your money back now because i'm not going to give you,
• 50:47
  and i feel that that's like every session that we have in clinic should be as
• 50:51
  well we're not going to give you the answers we're going to support you through
• 50:54
  this journey we're going to give you little pieces of information we're going
• 50:58
  to negotiate we're going to encourage we're going to motivate we're going to control,
• 51:02
  you know those people with unreasonable expectations about what we can do but
• 51:06
  we're going to be here we're signing up with you for your journey to support
• 51:10
  to facilitate some outcomes for you so you can be the best version of yourself,
• 51:16
  do you think we we we talk about cpd choice often do you think now because we
• 51:22
  were saying that if we move away from simply adding passive modalities to our toolkit,
• 51:28
  do you think if we just concentrated you know for this year for example on improving
• 51:33
  and understanding communication better,
• 51:36
  we would all be better therapists.
• 51:39
  Oh, I've got to say yes, haven't I? Otherwise, he's going to come along to my course.
• 51:43
  I think there's an awful, we've got to be so careful, it's a double-edged sword.
• 51:47
  People are talking much more about communication, behavior change and motivation interviewing.
• 51:53
  And I've seen this with guests of mine. but as always there's this thing that
• 51:57
  happens isn't there in our industry where suddenly the t-shirts start getting
• 52:00
  printed and kind of like suddenly,
• 52:04
  the do it in a day online or just sign up for this video thing and it just gets
• 52:10
  diluted and turned into a technique again so,
• 52:14
  there is some really interesting discussions going on and there's some great
• 52:17
  educators out there we've had them on the podcast.
• 52:20
  I think the work that Andy Hosgood and Andrew McCauley are doing with the Unbound
• 52:24
  Project is really cool about creating safe spaces.
• 52:28
  And I'm doing some work with them for that very reason.
• 52:32
  But yeah, we have to be careful because we love turning it into quick fixes
• 52:36
  and thinking it will solve anything.
• 52:38
  As you just said, I mean, which was a great quote from Brian Cox,
• 52:41
  like, if you think you're going to get answers now, then just get your money
• 52:43
  back from reception. Because I'm going to say, I'm going to say,
• 52:46
  Don't go on a CPD course. You should treat CPD courses the same way as you should
• 52:52
  be with your clients or patients in the sense that the answer to them getting better is inside them.
• 53:01
  And I think that's so important. If you can get that in your mind and do that
• 53:06
  little shift, then that can help a lot.
• 53:10
  And you should treat CPD the same way. If you go to CPD thinking they're going
• 53:13
  to give me some amazing information now and tell me how to fix my patients.
• 53:16
  Then you're going to be a little bit disappointed, I think, and that a lot of
• 53:20
  people are when they come back and they spend money and they think,
• 53:23
  this is great, this is great.
• 53:24
  And then they think everybody who's come to my clinic has got what we talked
• 53:26
  about. And then they start realizing, hold on, that can't be true.
• 53:29
  So you should look at a CPD opportunity as where it's going to encourage you to reflect.
• 53:35
  It's going to provide an environment where you feel the same as your patient should non-judged,
• 53:41
  valuable not inferior to the person who's taking it where you've got stuff which
• 53:47
  is going to guide what the actual course is about and how it's going to kind
• 53:52
  of change across the day or two or something,
• 53:55
  the reason i ask that matt is because you know i have 70 plus calls a week with members and,
• 54:02
  and possibly half of those calls in the last last week or so have been about,
• 54:07
  people saying they're feeling burnt out you know,
• 54:10
  they are at their limit you know how can we become a sustainable therapist you
• 54:17
  know so we're not getting burnt out and and i agree that cpd should be be,
• 54:22
  directed by two things either you've got to be passionate about a subject,
• 54:26
  or it's got to be really specific to your main client demographic there's no
• 54:30
  point in doing CPD otherwise.
• 54:32
  And I have lots of conversation with STA members. I say, okay,
• 54:36
  if you feel that way at the moment, I'm going to waive your CPD obligation for
• 54:40
  this year. But what I want you to.
• 54:45
  About what and reflect on why you're feeling like this at the moment so what
• 54:49
  we're trying to do i suppose,
• 54:51
  we we're encouraging a modern a modern thinking critically reflecting therapist,
• 54:58
  um and and this type of training to me is where we should be focusing,
• 55:04
  Yeah, definitely. I mean, it's, it's, you do such a valuable job and I'm not
• 55:09
  just saying that to big you up or anything, although I've got obviously so much
• 55:12
  respect for you and what you do, but you get to hear the truth.
• 55:16
  A lot of clinicians think that all their other clinicians are sitting in this
• 55:19
  ivory tower, lapping up everything, making loads of money, totally happy without
• 55:24
  any doubt, without any kind of imposter syndrome or whatever.
• 55:27
  And you know, that's not true because you actually hear the conversations,
• 55:31
  you know, and you know how many members, you know, know for example we got in
• 55:34
  the sda you know what percentage of them what they're going through and people
• 55:37
  trust you and they feel non-judged so they open up to you so,
• 55:40
  you you've got a real kind of access to the truth which a lot of clinicians don't have,
• 55:46
  and so that's the first thing and the second thing was yeah i think it's burnout
• 55:49
  is such a problem across health professionals allied health professionals equal
• 55:54
  to sports therapists and and i think,
• 55:58
  yeah communication different the shift we've talked about tonight can really help,
• 56:03
  because, and this is the wonderful Joe Turner, who's been a guest on the show of mehab.co.uk.
• 56:10
  Explains this really well.
• 56:11
  But as clinicians, we, because we're in this fixing mode, we take on that responsibility
• 56:17
  of helping someone lose weight or help someone do their exercises,
• 56:20
  get over the injury, get their park run or whatever it is, their PP.
• 56:25
  And if it doesn't happen, then obviously we've got that responsibility in our
• 56:28
  shoulders and it gets us down and we might not think it does and that we get
• 56:31
  home and don't worry about it but it is soul destroying
• 56:34
  when you're putting so much effort and you think you're helping this client
• 56:37
  and then they don't do the exercises or they go out and
• 56:40
  run up that hill again when you've told them don't do any hills anymore and
• 56:44
  you take it personally you get angry and you get irate and this is what contributes to burnout so.
• 56:48
  What we've talked about tonight is basically about changing that dynamic of
• 56:53
  where you're not fixing the patient. It's not your responsibility.
• 56:58
  Okay, your job is not to make that person do their exercises.
• 57:04
  What your job is, one of your jobs and the foundation of your job is to listen
• 57:10
  to that person and help create conditions through trust.
• 57:16
  And like I say, a safe space, psychologically safe, where they are going to
• 57:20
  listen to you and they're going to start opening up and talking about what the
• 57:24
  issue is, talking about what is causing them to actually not do the exercises or to,
• 57:30
  go for PB every kind of Saturday or Sunday.
• 57:33
  And and between the two of you you stop thinking they're the difficult person,
• 57:37
  they start feeling unjudged they start opening up and telling you what the problem actually is
• 57:41
  and then you help what they want to actually happen by helping them help themselves
• 57:46
  and that's really where our skills should be and during this we can give them
• 57:50
  some wonderful therapy manual therapy we could help them feel
• 57:54
  safe and secure through touch which is a massively important thing i think that's one of the reasons,
• 57:59
  why touches can be so therapeutic and useful in helping communication because
• 58:03
  we're not just talking about using our mouth and ears we're talking about everything
• 58:05
  with touch is a massive part of that.
• 58:07
  But yeah it takes a massive weight off your shoulders if you stop being a fixer
• 58:11
  and and and yeah i think that's so important it's so sad as you see the amount of
• 58:16
  burnouts and people leaving the industry it's a waste because we've got some
• 58:20
  wonderfully altruistic people who want to help make a difference but they're using a model,
• 58:24
  which sadly has probably come from their training whether it's degree or through
• 58:28
  diplomas which isn't really setting them up for success in many ways.
• 58:34
  You mentioned in a previous answer about the Unbound Project.
• 58:39
  Can you just give us some insight into what that is, when it takes place?
• 58:44
  How can people get involved? Yeah, I'm glad you mentioned that.
• 58:47
  I mentioned it before. I've got so much respect. Andy Hosgood,
• 58:49
  people might know if they came to the STA conference in association with the
• 58:53
  Hands-On Hub in Exmouth.
• 58:54
  Andy Hosgood and Andrew McCauley set up this thing called the Unbound Project,
• 58:59
  which I've got so much time for because basically they're all about creating
• 59:03
  space for exactly these kind of conversations.
• 59:06
  They recognize that a lot of clinicians measure their success against this idea
• 59:12
  of what your competition is
• 59:14
  doing and this idea that everyone else is not having the problems you are.
• 59:18
  And they're trying to get clinicians to come together and trying to create a
• 59:22
  space where people do actually open up and don't see your colleagues as competition,
• 59:28
  but more as a chance to share problems and collaborate and find solutions to problems.
• 59:32
  And sometimes that solution is just realizing that the person down the road
• 59:35
  from you is not the enemy.
• 59:37
  And they may well have a great idea for you or simply just knowing that they're
• 59:40
  going through the same thing.
• 59:41
  And now you're going to talk about it is so powerful. So they create a lot of
• 59:45
  this at the moment is, well, it is, it's all just free.
• 59:47
  So they've already had quite a few meetings. Look up the Unbound project on Instagram or Facebook.
• 59:53
  We'll make sure link goes into the show notes. But yeah, they're all about this
• 59:57
  safe space and for clinicians to open up and talk things through.
• 1:00:00
  And this is so important because if you start doing that, if you start feeling the benefit.
• 1:00:06
  Of being in a safe space and being able to talk what your worries are,
• 1:00:09
  then you'll be able to create that same sort of scenario for your patient and
• 1:00:13
  client who ultimately a lot of them are looking for that as well.
• 1:00:17
  Because also don't fall into the trap of thinking that just because someone
• 1:00:19
  comes in and they all look kind
• 1:00:22
  of like, you know, confident and ready and without a care in the world,
• 1:00:26
  come on now, we're old enough and wise enough to realize that it's not just
• 1:00:30
  neurodivergent people who mask, you know, everybody masks, particularly when
• 1:00:34
  they're coming to like a healthy person who's supposed to be great at running
• 1:00:37
  or a strength and conditioning coach, everyone puts on a little mask.
• 1:00:42
  So don't think that just because that person comes in and looks like they haven't got,
• 1:00:46
  any weight on their shoulders open the conversation show curiosity and you realize
• 1:00:51
  that as human beings we've all got stuff going on and and part of our position
• 1:00:55
  is to help talk people through that and help them find the solutions so yeah
• 1:00:59
  the unbound project so i'm babbling on.
• 1:01:01
  Thank you actually you know a couple couple more minutes matt you mentioned
• 1:01:06
  you had your course dates up there if somebody wanted to attend your course
• 1:01:11
  i know you've spoken a little bit about content but,
• 1:01:14
  what what's the one thing that they'll be able to take away from today or equally
• 1:01:18
  if they attend your course.
• 1:01:21
  Yeah. So yeah, course dates, just go to mattphillips.education.
• 1:01:25
  I've put so much time into changing everyone's life.
• 1:01:29
  It's been ridiculous and I've just focused so much on it. So yeah,
• 1:01:33
  go along to mattphillips.education, have a little look through there and everything
• 1:01:36
  you can need for therapy showing that is on there in the course page or the
• 1:01:39
  end page and on the unbound project as well.
• 1:01:41
  But yeah, from the, from the course, like I said, it kind of brings together,
• 1:01:45
  I think speaking with Matt Lowe, we did one episode, which just kind of looking
• 1:01:51
  at philosophy. And philosophy, we kind of switch off that. We're like, oh, yawn, yawn, yawn.
• 1:01:56
  But again, this is why I go back to Socrates and go back to the great classic
• 1:01:59
  philosophers, because before psychology, it was philosophy.
• 1:02:02
  Psychology came along when it turned philosophy into a science and started measuring
• 1:02:06
  things. But philosophy is where so many of the answers are. So on the course,
• 1:02:10
  I try and bring together philosophy.
• 1:02:12
  And I think in future, healthcare is going to be very much linked with philosophy.
• 1:02:16
  It's not going to be a dirty word or something we feel that we can't talk about.
• 1:02:20
  And I think philosophy will help politics because politics and philosophy need to work together.
• 1:02:25
  But so, yeah, I bring together philosophy, communication, science,
• 1:02:29
  a lot of MI because I do love motivational interviewing approach and put it
• 1:02:33
  into clinical practice.
• 1:02:34
  Even though I'm not in clinical practice myself, I have done kind of 10 years
• 1:02:38
  at least in clinical practice.
• 1:02:39
  And like I say, in education, there's such a big crossover so but yeah in terms
• 1:02:44
  of like what are people what listeners to take away from today then i think
• 1:02:50
  it's i i do like the simple kind of phrase that.
• 1:02:54
  Most human problems aren't solved through better explanations.
• 1:02:59
  And I think if you look at your own life and look where somebody has tried to
• 1:03:03
  just explain to you what's going
• 1:03:05
  on, that hasn't made the pain or the distress or the anxiety go away.
• 1:03:10
  Particularly if it's at a time where you're feeling very vulnerable and you're in pain.
• 1:03:13
  It's having someone, I think, I don't want to generalize, but I think guys love solving problems.
• 1:03:19
  I don't know whether it's in our genes and I'm stereotyping a little bit because
• 1:03:22
  I know women who are great problem solvers, but,
• 1:03:25
  we know in relationships that wherever your partner is, if you jump in there,
• 1:03:29
  with a solution every time they're upset or distressed, you're probably going
• 1:03:32
  to get either a physical or mental attack of some form.
• 1:03:35
  And we need to treat our patients and clients in the same way.
• 1:03:40
  The clients who come to us in pain, maybe through injury or whatever it is,
• 1:03:45
  their problems are going to be solved better through understanding, okay?
• 1:03:50
  And when we're talking about patients, or it could be learners,
• 1:03:53
  or it could be the difficult staff member, change starts when people feel understood.
• 1:04:00
  And if you're going to make someone feel understood, you've really got to ravel
• 1:04:03
  it back and change a few chips in your mind.
• 1:04:05
  So that's why I'd like people to kind of, the listening and they're trying to
• 1:04:08
  take something way is just just bear in mind and we know the answers ourself
• 1:04:12
  that if someone comes to you with a problem an explanation is probably not going
• 1:04:16
  to help maybe eventually it will but not initially,
• 1:04:19
  i find it interesting that before before the advent of the internet and and
• 1:04:25
  now we're artificial intelligence,
• 1:04:28
  this has been around for for centuries you know the ancient greeks were the
• 1:04:32
  original ai weren't they everybody thought that they had all the answers uh
• 1:04:36
  some are proven and some are disproven, but that's an,
• 1:04:40
  interesting conversation for another day.
• 1:04:42
  Finally, Matt, you mentioned at the start of this podcast about identity.
• 1:04:49
  I'm in most people's phones as STA Gary. What would you like to be in people's phone as?
• 1:04:56
  Because I had you in my phone as Matt Runchat Live.
• 1:04:59
  That's changed now. But what do you want to be identified as?
• 1:05:04
  That's so cool. That's so cool. I think really giving up Munchet Live was hard,
• 1:05:10
  but I think eventually I chose Matt Phillips' education.
• 1:05:15
  I didn't like it initially because I think the word education sometimes takes
• 1:05:18
  us back to this idea of school the same way as the clinician standing over the
• 1:05:23
  patient and telling them what it is. But for me, education is not about that.
• 1:05:27
  And for me, education is about going on a journey with someone and sharing time
• 1:05:32
  together and going backwards and forth.
• 1:05:35
  And then probably both of you learning from the experience. That's the ideal
• 1:05:38
  form of education. So I went in the end with Matt Phillips Education.
• 1:05:42
  So yeah, if anybody wants to change my name in the, please keep me in your book,
• 1:05:45
  in your phone, in your book. How old are we?
• 1:05:48
  Please keep me on your digital device, but maybe from Matt Phillips,
• 1:05:52
  Run Chat Live to Matt Phillips Education. That'd be, that'd be wonderful.
• 1:05:56
  All right, Matt. Well, thank you very much for giving up your time this evening,
• 1:06:01
  and being in the hot seat and answering my questions.
• 1:06:05
  We appreciate all the work you do on the podcast and we look forward to getting
• 1:06:09
  back to normal next week.
• 1:06:12
  Thank you, Gary. Thank you for the opportunity. I am exhausted.
• 1:06:14
  And even this has been a learning experience because I realize how exhausted
• 1:06:17
  my guests must be now. It's given me a wonderful reminder of how exhausting
• 1:06:21
  it is to think of answers all the time. I'm gladly going to jump back into the hosting next week.
• 1:06:26
  So thank you, Gary, for everything you do as well. It's amazing working with
• 1:06:29
  the STA because of you, basically.
• 1:06:31
  So I'm glad we did have that conversation in a car park. That sounds a bit dodgy.
• 1:06:35
  What was it, a car park? 15 years ago.
• 1:06:39
  Around what car was it at the time it was an estate or something with a hatch
• 1:06:42
  over yes it was ngztt yeah british racing green if i remember rightly,
• 1:06:48
  it really was it reminds me of mine do it really was like an arthur daly dennis
• 1:06:52
  water can't shake over the bonnet sort of thing yeah it was it's it's great
• 1:06:57
  it was um definitely a celebrated time so yeah thank you right so yes,
• 1:07:02
  next week I will be back in the hot seat just before I forget thank you people
• 1:07:07
  did join us live I hope that wasn't boring thank you,
• 1:07:10
  podcast listeners I hope you've enjoyed this and Sir Glenn Murphy has said hey
• 1:07:15
  great chat guys thank you Sir Glenn every single show Sir Glenn turns up it's
• 1:07:19
  amazing and thank you for everybody who comes along we love recording it live
• 1:07:22
  it just makes it spontaneous,
• 1:07:24
  and we also appreciate everyone who downloads it as well,
• 1:07:27
  so yeah next week I am going to be back in the hot seat and I'm going to be.
• 1:07:34
  Book with Ruth Duncan, which is fantastic. We don't talk about names from the
• 1:07:38
  past. Everybody's had a book with Ruth Duncan on the front, haven't they?
• 1:07:41
  It's fantastic. And Susan Finley.
• 1:07:43
  So I'm so excited. And this is very much part of the collaboration which the
• 1:07:47
  STA is trying to spearhead. And it started, I think, maybe probably last year
• 1:07:51
  at Therapy Show when we all got together
• 1:07:52
  on a stage. But I remember we had concentrations. It was concentrating.
• 1:07:57
  But we had conversations at the STA stand with Ruth and Susan. And it was wonderful.
• 1:08:02
  And I'm very excited that they're going to be coming on the show next week to
• 1:08:06
  talk about examining the role of the General Counsel for Manual Therapies,
• 1:08:11
  which some of you will know better as the GCMT.
• 1:08:14
  Ruth Duncan is the chair of the GCMT and Susan Finley is the vice chair of the GCMT.
• 1:08:19
  So they're going to be joining me next week really as part of this collaboration
• 1:08:24
  and we're all in the industry. We're talking much more than we used to,
• 1:08:26
  which can only be a good thing.
• 1:08:28
  So it ties in nicely with the communication. So we're going to be looking at
• 1:08:30
  what the General Counsel for antiotherapies does.
• 1:08:33
  And we're also going to be talking about, there's going to be a little bit of
• 1:08:35
  a flavor this month of what we can do to help improve education.
• 1:08:39
  What are we going to do about some of the alternative forms that are being put
• 1:08:43
  out there, like the very short online courses, which hands on heart.
• 1:08:47
  We all kind of know it's not going to help you that much. There might be a place
• 1:08:50
  for it somewhere, but it's really taking over and it's not doing our industry very good.
• 1:08:55
  It's almost like doing the opposite of everything that Gary and I and people
• 1:08:59
  like Ruth and Susan have been doing for years. So we're going to talk about
• 1:09:02
  that and how we deal with it in a calm, listening way.
• 1:09:06
  So that's very exciting. And then the week after, I think we're going to be
• 1:09:09
  talking to Kate Williams of the Society of Sports Therapists and Sarah Catler
• 1:09:13
  as well from the STO is going to be doing it.
• 1:09:14
  We're going to kind of be continuing that conversation a bit looking at sports
• 1:09:18
  therapy and the differences between vocational degrees is it a,
• 1:09:23
  one against the other or is there room for everything and that sort of stuff
• 1:09:26
  so it's going to be collaboration as well so it's going to be a great couple
• 1:09:28
  of weeks coming up really excited about that.
• 1:09:31
  And you can be around for us as well gary aren't you we're not saying goodbye
• 1:09:33
  to you you're going to be yeah that's gonna be amazing so yeah that's what's
• 1:09:37
  coming up if you can join us then all you've got to do is come along to,
• 1:09:42
  the Sports Technology Association YouTube channel at eight o'clock,
• 1:09:44
  which is BST British Summertime.
• 1:09:47
  Or you can come along to YouTube. Sometimes technology did tonight gets in the
• 1:09:52
  way only about six out of 292.
• 1:09:55
  But I would, if Facebook does go down for whatever reason, then jump onto YouTube and vice versa.
• 1:10:01
  But we will be here in one form or the other at eight o'clock as we are every
• 1:10:05
  Tuesday on the STA collision podcast. So thanks, Gary.
• 1:10:10
  Again i'm totally inaccurate i'm so exhausted i'm looking at my guests in the
• 1:10:14
  ua now i'm gonna be very gentle with ruth and susan next week i'm absolutely wiped out
• 1:10:19
  right thanks everyone joined us live as well thank you very much the podcast
• 1:10:22
  please leave a rating and a review maybe not for tonight's episode if it wasn't
• 1:10:24
  that interesting skip that one
• 1:10:26
  but yeah give us some love for the other 291 appreciate it until then,
• 1:10:30
  take care of yourselves and take care of each.