Last Updated Thursday, January 19, 2012 12:09:25 AM
Therapists utilize a variety of methods to treat patients, but before treatment even begins there are a number of things that must be taken into account. For example, what is the treatment for? Which type of treatment will be most effective, and to what degree should that treatment be applied? The therapist must also take into account the physical as well as psychosocial aspects of each individual patient, and all of this combined requires something called clinical reasoning.
Clinical reasoning is simply a practical way to make decisions in your role as a healthcare provider. It is a problem-solving process based on individual patient background and evaluation, and at its essence clinical reasoning answers the following questions:
- How do we know what to do?
- How do we decide what to do next?
- How do we know when to stop doing it?
In daily practice, clinical reasoning can help expedite treatment and provide both the patient and the therapist with a comfortable level of therapeutic intervention. In other words, by providing the patient with clear assessment results the therapist can confirm the patient’s status and demonstrate that certain deficits may be evident with or without treatment. From there, and appropriate plan of care can be developed.
Validating Therapy Services
Nowadays the value of clinical reasoning has become increasingly evident, particularly with regard to validating therapy services. As national healthcare coverage in the United States becomes more 
stringent and selective, medical services that were paid for easily in the past are now coming under increasing scrutiny by third-party payors. Using clinical reasoning and an evidence-based model, therapists can confidently “prove” their treatment techniques to third-party payors as well as to patients who pay for therapy as an out-of-pocket expense.
Under the Prospective Payment System (PPS) it will be important to streamline therapy treatments and at the same time maintain ethical responsibility to provide patients with the best possible treatment. Clinical reasoning is a method that can be used toward that goal.
Ensuring Ethical Treatment
How do therapists know if they are providing right and good treatment? How does a therapist begin to establish principles of practice? A clinical reasoning model can help to establish these characteristics in the following ways:
- By providing the therapist with a problem-solving formula, it can help to determine if a certain treatment is appropriate.
- By providing the therapist with a flexible guideline, clinical reasoning can establish a set of principles or ground rules that can be followed when providing patient care.
- By continuing the concept into an evidence-based model, the therapist can further justify or validate the treatment and problem-solving skills for the third- party payor as well as the patient and therapist.
A Multitude of Benefits
The benefits of utilizing a clinical reasoning approach in the therapy setting are numerous. For therapists, it helps construct a format or model around which to work. Many successful entrepreneurs will profess they became successful due to the fact that they developed a plan. Personally and professionally the use of a plan is beneficial to reaching goals, and clinical reasoning is a guide that therapists and other healthc
are professionals can use to reach those goals.
Student therapists also benefit greatly from the use of clinical reasoning, as it provides them with a fixed system to follow in order to establish set routines for patient care, treatment planning, and professional development. Student therapists can utilize technical data to help select treatment and foster assurance in their clinical judgment to ensure proper and effective treatment. When clinical reasoning is applied, patients reap the rewards of an optimal treatment plan based on their specific needs.
Finally, clinical reasoning provides a significant benefit with regard to third-party payors. It is to the therapist’s benefit to provide third-party payors with the information necessary to ensure timely and complete reimbursement. Clinical reasoning helps therapists validate treatment techniques and is an excellent addition to the use of assessment tools, evidence-based therapy, and appropriate documentation.
Clinical Reasoning and the Future of Therapy
Chances are the majority of therapists already apply some form of clinical reasoning when determining a safe and effective course of treatment for their patients. If not, it is a worthwhile approach—not only for the healthcare environment of the country, but also for the patient and for the practitioner in the long run. Utilizing clinical reasoning means fewer therapists will practice “heroic” therapy (providing therapy to anyone and everyone) and more therapists will feel a greater sense of confidence knowing what they are providing is valid, justifiable, and worthwhile.
To learn more about clinical reasoning, including its application and effectiveness in individual as well as group therapy settings, visit our comprehensive online course Clinical Reasoning.
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