Addressing Uncomfortable Health Topics as a Therapist

By David Garner MOT, OTR/L, AC



As therapists (PT, OT, SLP) we wish the best life possible for our patients. Sometimes we see them making unhealthy decisions that may impede their recovery. How can we approach these topics with respect in a way that is educational without being judgemental? Topics I'm referring to including losing weight, quitting smoking or drinking, and other counterproductive lifestyle choices. For many people these behaviors may involve addiction or anxiety. They likely know they should change, but it's hard. Perhaps they have tried in the past and were met with poor results. 


We are not generally experts in these areas, but we can educate our patients about healthy life choices as well as resources that may support their success. It can be awkward to bring up these topics with patients. So here is what I have found to help me approach the subject respectfully without any awkwardness. 


Begin by ensuring the conversation takes place in a private setting. Some patients care more about this than others. Begin the conversation by acknowledging their own experience. For adults that are overweight or smokers, they have probably heard the message a thousand times that they need to change. You are probably not the first to communicate this to them. I say something like, “You are probably aware that ____ negatively impacts your health.” 


Next, I will emphasize how this issue currently impacts their recovery. For example, smoking severely impairs tissue healing, also it exacerbates neuropathy symptoms. They may be much more motivated to succeed if they understand how the unhealthy practice impedes their recovery and return to PLOF.


Lastly, I will let them know I’m sharing for the purpose of allowing them to make educated choices. My goal is not to place judgement or shame. 


If they seem interested, I will share resources or educate them on medications available that may aid their goal so they can discuss with their doctor. Community and online resources may be beneficial. The key is to provide support, not pressure. 


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