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PTA Blog Talk

Getting Too Close

Published August 29, 2012 10:45 PM by Jason Marketti

I don't know how many times I've seen this behavior by therapists in various clinics and facilities I've been in. I call it "helicoptering." It's when the therapist hovers over the client or when the therapist is too close to the acceptable comfort-level space of the patient, usually 12 inches.

I've seen therapists swoop in extremely close to a patient's face while he lays vulnerable supine in bed. From this position, the therapist directed the patient's every move. I witnessed a therapist sit directly in front of a patient with one knee between the patient's legs. As the patient moved back, the therapist scooted forward, getting even closer to the patient. I understand our profession is hands-on and we often have to touch the patient to facilitate movement, but when speaking with patients we should leave some professional distance between us and them.

I generally ask permission or tell the patient where I am going to touch before I do so. I've even told patients to tell me if they get uncomfortable with what I'm doing. When they do, I back off and give them space from me and any discomfort from the stretching or exercises. If a person hovered over my bed or put his knee between my legs as he was talking to me, he would leave with a swollen head from my two fists pounding his ears.

As a general rule, therapists should use some social norms with patients. Would the therapist stand or talk that close to a friend of a friend's face? We are strangers to the patients when we first meet and have to establish trust within 10 to 30 seconds of meeting them. The same rules should apply as when first meeting someone. Keep your distance and ask for permission.

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About this Blog


    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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