Appearance 

It is important to consider what clothing we wear and through this, what message we are trying to convey to the patient.

The standard practice is to not wear a uniform, the standard physio blue and white. In a place of work there will be a policy on dress code which will normally stipulate not wearing items such as blue jeans, and the dress code in mental health is generally far more liberal than in physical health. In my experience, the only clinicians in mental health who wear a uniform are the physiotherapists. I assume this is purely cultural and embedded in that mental health physiotherapy is a relatively young and underdeveloped specialism.

Thought can be put into this area to improve outcomes, there is not one way to do things, and it will depend heavily on the individual clinician and their personal attributes as to how they choose to dress.

There are a few different options you can pick depending upon the image you wish to portray and any separation which you would like to define.

If you wear a uniform, you are defining yourself as ‘clinical’ and more part of the physical health world than the mental health world. This will separate you from the identity of your mental health colleagues around you in the eyes of a patient. You may wish to wear casual clothes like your mental health colleagues. This will separate you from other physiotherapists and therefore the physical health world in the mind of the patient. This could be incredibly important if that patient has had a series of bad experiences with physical health clinicians. It may give you a window of opportunity to present yourself as different and relieve you of the baggage from previous negative experiences with physical health clinicians. It also may present you as unprofessional, or casual, it may diminish the weight of which your opinion holds in the mind of patient. You may bond well with the patient and develop a happy but ultimately ineffective relationship. There will be many patients who when coming to see a mental health physiotherapist will be expecting that physio to be in uniform. If they are not only out of uniform but in casual dress, it may undermine their authority when giving advice or making suggestions. When somebody goes to see a mental health practitioner, the cultural norm is for that clinician to be wearing ‘everyday’ clothes. However, I would suggest, the expectation is different for physiotherapists working in mental health. There is likely to still be an expectation that the physio would present themselves as ‘clinical’. My reasoning for this is patients see no intuitive link between the physical therapist and mental health. We are seen as someone from physical health sitting in mental health. A cuckoo if you will.

Casual clothes will certainly help when out in public with a patient by not breaking confidentiality through appearance.

You could wear sports attire, tracksuit bottoms, T-shirts, etc. This could be something different to the classic blue and white physiotherapy colours. This can set you apart from the physiotherapy world and the mental health world while also remaining somewhat clinical. However, there is the possibility that it can make you appear somewhat lowbrow. So, it really depends upon what sort of physiotherapy service you would like to offer, and whether this image tessellates with it. If you want to offer a complicated clinic treating physical pain then probably don’t, but if you want to do exercise promotion then it will be fine. That is not to denigrate the difficulty and complexity of exercise promotion. The importance is the image of the service and the attire matching. One has a complexity which is self-evident to the patient. The other has a complexity of behaviour change, this complexity is hidden and needs to remain hidden for it to be effective.

Your personality may be such that you come across rather intellectual and intense, so you would need to soften this image through the use of sports clothes for example. What a person wears needs to be considered in the context of other aspects of that individual’s presentation. You could wear clothes to compliment how people see you or you can wear clothes which will contrast how people see you to soften or harden your image. If you are a friendly, chatty character, you may wish to wear more serious clothes to give you the gravitas that your personality may be naturally missing. If you are a rather intense serious character, you may wish to wear some more friendly clothes and dress down.

I used to dress smartly in a shirt, trousers and shoes. I would do this because I wanted to be separate from the physiotherapy world. And separate from the mental health world and the sports world. I wanted to be somewhat ambiguous. When with patients I was very smiley and chatty. So, the clothes complimented well.

You may wish to consider how you are viewed by your colleagues in terms of what you wear. Creating deliberate separation may be viewed negatively by your peers. Dressing to create separation has it down sides. It may increase effectiveness in clinical work but that separation from the herd, from the team could also be a negative step.