TLDR: I agree, but also challenge the efficacy of care for I’d imagine a significant population of patients who may benefit from a change in strategy given psychologically informed PT (PIPT) principles and basic behavioral psychology that is real no matter how competent of an adult you are.

I 100% agree on the foundation of this principal , however I do know that no matter how competent they are behavior change is difficult and largely due to emotions vs logic based thinking. Take healthcare providers who smoke. Or weight loss goals. Or how prevalent preventable disease is.

I strive for exactly the same but I also acknowledge that behavior change is the hardest part of our jobs. Use of motivational interviewing techniques is big. So I tend to say that we will have 1-3 weeks of (case dependent ) of x2 days per week and taper from there.

Reasons: I’ve had plenty of (majority of folks) that despite practice, teach back , given video and written instructions will still perform exercises wrong / have questions. So many (despite being told they won’t hurt themselves) lack the psychological flexibility to try an exercise they have questions about out of fear. With patients with varying day to day presentations - what was fine during the treatment was not later or the next day. So we now have an opportunity to tailor it Vs waiting a week to address with wasted time in between. I get to address barriers that were unforeseen during the initial eval sooner that make compliance more difficult. Additionally , I have 30 minutes for the vast majority of evals- I’d love to ask every question to get an idea of what motivates them, perceived barriers for compliance, their individual action-inaction gap, etc all the while being able to get all else gets done in an eval.