Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care.
active inference
manual therapy
musculoskeletal care
osteopathy
pain
physiotherapy
therapeutic alliance
touch
Journal
Frontiers in behavioral neuroscience
ISSN: 1662-5153
Titre abrégé: Front Behav Neurosci
Pays: Switzerland
ID NLM: 101477952
Informations de publication
Date de publication:
2022
2022
Historique:
received:
15
03
2022
accepted:
24
05
2022
entrez:
18
7
2022
pubmed:
19
7
2022
medline:
19
7
2022
Statut:
epublish
Résumé
Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness and the therapeutic alliance. In this hypothesis and theory paper, we present an entwined model that combines touch for alignment and active inference to explain how the brain develops "priors" necessary for the health care provider to engage with the patient effectively. We appeal to active inference to explain the empirically integrative neurophysiological and behavioural mechanisms that underwrite synchronous relationships through touch. Specifically, we offer a formal framework for understanding - and explaining - the role of therapeutic touch and hands-on care in developing a therapeutic alliance and synchrony between health care providers and their patients in musculoskeletal care. We first review the crucial importance of therapeutic touch and its clinical role in facilitating the formation of a solid therapeutic alliance and in regulating allostasis. We then consider how touch is used clinically - to promote cooperative communication, demonstrate empathy, overcome uncertainty, and infer the mental states of others - through the lens of active inference. We conclude that touch plays a crucial role in achieving successful clinical outcomes and adapting previous priors to create intertwined beliefs. The ensuing framework may help healthcare providers in the field of musculoskeletal care to use hands-on care to strengthen the therapeutic alliance, minimise prediction errors (a.k.a., free energy), and thereby promote recovery from physical and psychological impairments.
Identifiants
pubmed: 35846789
doi: 10.3389/fnbeh.2022.897247
pmc: PMC9280207
doi:
Types de publication
Journal Article
Langues
eng
Pagination
897247Informations de copyright
Copyright © 2022 McParlin, Cerritelli, Rossettini, Friston and Esteves.
Déclaration de conflit d'intérêts
GR leads education programmes on placebo, nocebo effects and contextual factors in healthcare to under- and postgraduate students along with private CPD courses. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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