Confronting Ableism in our PT Practice

These are two phrases I hadn’t though very much about until reading a recent article by Schwab and Silva.1 I am now thinking about them a lot more, and specifically about how both are very important for physical therapists and the patients and clients we serve. Intellectual humility is the recognition that one’s beliefs may be incorrect and that a particular personal belief may be fallible. It is accompanied by an appropriate attentiveness to limitations in the evidentiary basis of that belief and to one’s own limitations in obtaining and evaluating relevant information.1 It especially resonates with me as it encourages reflective thinking, curiosity, openness and open-minded thinking, and an intrinsic motivation to learn- values that are at the core of my efforts through PT Learning For Practice.

Aversive ableism refers to individuals who are progressive and well intentioned, but engage in implicitly biased thoughts or actions toward disabled individuals- low explicit prejudice but high implicit prejudice- and genuinely do not believe they are prejudiced. This can lead to an outsider dominant approach to interactions with these individuals.1 For example, in reflecting on my own career, decisions about clinical interventions, research, and disability have historically often been made using an outsider-dominant approach without consulting these individuals. In addition, there is a very small representation of disabled individuals in the physical therapy profession despite the explicit commitment and efforts toward increasing diversity.

How should we use the intellectual humility framework to minimize aversive ableism in our individual and collective physical therapy practice? First, I believe it is important to acknowledge the complicated relationship between disability and our profession, where we focus so much of our attention on the importance of “normal” or “typical” movement. As Schwab and Silva point out, ideas about normality and independence remain central to physical therapy assessments and interventions despite people with disabilities expressing that these are not necessarily meaningful endpoints.1 Instead, we should strive toward approaching all clinical encounters with intellectual humility and an openness to learn as much as we can about each individual so that we can collaborate to help them achieve their goals, which often do not include “normal” movement patterns. Involving individuals with disabilities in research studies and in teaching students and practitioners should also be a priority, and we should expand our efforts to include these individuals as members of our profession. Lastly, the concept of intellectual humility should be explicitly taught to students and new practitioners so that this becomes a core component of our professional identity.

*Note: I intentionally alternated my use of person-first terminology in recognition of the diversity of these individuals’ language preferences.1

**Note 2: In conjunction with several colleagues including an individual with disabilities, I am developing a CE course related to this topic and look forward to sharing more information on this sometime in the very near future.

  1. Schwab S & Silva P. Intellectual Humility: How Recognizing the Fallibility of Our Beliefs and Owning Our Limits May Create a Better Relationship Between The Physical Therapy Profession And Disability. Physical Therapy. 2023; 103: 1-6

One response to “Confronting Ableism in our PT Practice”

  1. Thanks Joe. This post hit home.   I was in a large meeting of EI professionals yesterday; some of the comments made during the meeting hit on your points.  I agree we need to teach students and practicing professionals about intellectual humility and help practitioners reflect more about actions and statements that may be ableist (?). 

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