If Jackson Pollock came in with shoulder and neck pain which were affecting his ability to paint, could you treat him? Of course – his body and biomechanics would be the same as anyone else. So why present him as a hypothetical patient? He reportedly dealt with clinical despression and substance abuse. What would you do differently with him? My case study for graduation (which I hope to have published) is on a patient with neck and shoulder pain who also has severe mental illness and struggles with substance abuse (this is known in the literature as dual diagnosis, or co-occurring disorder). While I present the treatment and result, I also address adherence and what I did to try and improve it.
Adherence is low already in the SMI population – add on substance abuse and there is a whole additional realm of interpersonal interaction and issues with adherence (there are not a lot of studies in general that are specific to this population, and none relating to PT). If I don’t get it published, I will publish some or all of it on the blog – stay tuned. Now I need to get back to writing it.