“You Actually Care”: Why Soft Skills are the Key to Effective Therapy
Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist
The other day, a patient’s spouse looked at me, and said incredulously:
“It’s like you really understand her and actually care. You’re not just going through the motions.”
I instantly teared up, because I’m a giant crybaby, but it really got me thinking.
I do care. And the fact that he said it with such surprise broke my heart. Because while it felt so natural to me, to him, this wasn’t the norm — and that’s is a problem!
It also reminded me that what we are doing is different—and it’s working! This is exactly what I want every patient and family to feel when they work with us at Healthy Aging Physical Therapy. And it’s why I’ve built our practice, intentionally, to protect and promote what I think is the number one differentiator in great care: effective soft skills.
The Problem: A System That Strips Away the Human Side of Health Care
In today’s healthcare system, connection is rare. You go to your MD and they are typing more than they talk. The visit is often less than 15 minutes. There’s little to no time to ask questions. Patients rarely feel truly heard.
In many outpatient therapy clinics, time with your therapist is limited. You might spend 15-30 minutes with your clinician, but the rest of your session is with an aide or tech, often in an open gym, surrounded by other patients. While the shared gym environment is motivating for some, it can make it difficult for others to be open or vulnerable.
Home care should feel more personal, but even that has become transactional. With nursing shortages, therapists are being asked to address issues beyond their scope. Visits are often 30-40 minutes at the most, and a large portion is spent on answering multiple-choice questions for Medicare and making sure those are complete to ensure payment.
Please know, none of this is said to slight any of these healthcare providers — clinicians are, by and large, well-meaning individuals working under extremely challenging conditions. Rather, these are symptoms of a systemic issue. Financial and administrative burdens, staffing challenges, and healthcare inequity are strangling our system. And while clinicians struggle to get through the day, the ones truly suffering are our patients.
The Solution: Shifting to Model That Puts the Care back in Healthcare
When I started seeing patients under the Healthy Aging model, something shifted for me. I had spent years in settings where I felt I had to rush through the "subjective" portion of an eval, get through the history in 10 minutes or less so I could move on to the "real" work: strength testing, range of motion and outcome measures.
But once I gave myself permission to slow down and listen, my evaluations transformed. It started taking me 30, or, sometimes more, minutes to get through my subjective - not because I was inefficient, but because I let myself get curious. And the more curious I became, the more I learned. Learning more about my patients helped me design better plans for their care. And I found that as my relationships grew stronger, their outcomes got better.
I needed that time to get to know my patients beyond their past medical history and med lists. I wanted to know more than just their goals, but about their lives:
Tell me about your home. Have you lived here a while? Did you raise your family here? Is it important to you to age in place? Have you looked into supported living settings or do you want more information?
Who helps you day to day? Do you have family, friends, caregivers involved in your life — or need help finding more support? What needs feel unmet?
Tell me about your grandkids and your pets, your church groups and what you do in the community. How do you spend your days?
How are you feeling — not just physically, but emotionally? Are you in a place where you can focus on therapy, or are there other issues that need to be addressed first?
How is your sleep? Appetite? Hydration? Do you have access to healthy food?
How do you feel about exercise? Love it? Hate it? Have you had PT before? Was it helpful? What gets in your way of being more active?
These questions aren't luxuries. They are essential. They help me develop a plan that reflects who they are, where they are, and what matters most to each of them.
That single shift, from checking boxes to checking in, changed everything.
Structuring a Practice Centered on Soft Skills
It wasn’t enough for me to work this way. I wanted our whole practice to reflect this approach. That meant building a structure that not only allows for soft skills, but rewards them. How do we do this? From hiring to training to the way we structure our sessions, compassionate, patient-centered care is the foundation and everything stems from there.
We hire for heart, not for accolades. When I interview a prospective therapist or personal trainer, I’m not looking for specialty certifications, or awards on their resume. I’m looking for the people that care. Therapists and trainers that care about the work they do, the patients they work with and the colleagues they work beside. I’m always on the lookout for someone that has something special to give, who wants to learn more, and collaborate with their peers.
We book our visits for a full hour. After years of rushing around in home care, I didn’t want to feel rushed anymore. Our patients deserve better. They need time at the beginning to talk and settle in, and time at the end to wrap up, reflect and make a plan for the next week. After treating this way for five years now, I can’t even imagine going back to a shorter visit.
Our clinicians are paid for time, not for productivity. If one of our therapists spends an hour and a half with a patient, they are paid for an hour and a half of their time - even if half of that was dealing with a non-billable need. It happens! This frees our therapists to be present and focused and without worrying about productivity quotas or time crunches.
I train each of our therapists to evaluate with intention. When someone joins our practice they accompany me on an evaluation before going out on their own. I model what I teach, and have systems in place to help guide them in asking the important questions. I can’t tell you how many times I finish an evaluation and a patient or their family says to me ‘I’ve had a lot of PT, and no one has ever asked me these kinds of things.’ This is how I know I’m on the right track. And when a patient feels seen and understood, they are more willing to do the work.
We lead with our core values. They’re printed on the first page of our patient booklets, woven into our orientation, and reflected in how we speak, act, and show up for care.
Healthy Aging Therapists are:
Patient Centered + Holistic
Empathetic + Compassionate
Collaborative + Approachable
Fitness-Forward + Functional
Evidence-Based + Education-Focused
And our mission statement says it all:
Healthy Aging Physical Therapy delivers specialized outpatient-at-home physical therapy, occupational therapy, and wellness services to support optimal aging for older adults, individuals with Parkinson's Disease, and those with complex medical needs. Our unique in-home model reduces barriers to access, is driven by patient-centered goals, emphasizes education, and embraces a holistic, whole-health approach. We believe in movement as medicine, that every body has the ability to improve, and that above all else, kindness matters..
5 Soft Skill Tips for Therapists Who Want to Provide Better Care
If you’re a therapist reading this and thinking, "I want that, too!" here are my top 5 tips to improve your own soft skills and get better results:
1. Take the time to talk, even if it takes time away from something else.
Taking that extra time not only at evaluation, but at each session, to engage, ask, and listen will pay dividends in patient engagement, motivation, and success. So what if you didn’t get to complete that Berg today or see how they did on the stairs. You’re in it for the long game and not everything needs to be accomplished on day one - you can always get to it next session. That time spent talking isn't wasted - it's essential.
2. Don't write off the "hard" ones - they are the ones that need your care the most.
Frustrated by your ‘unmotivated/unwilling’ patient? Don't just write them off as lacking potential, being non-compliant or unwilling to participate. These are the ones to DOUBLE DOWN ON. Really dig in - get curious! Why are they struggling to participate or follow through? Are they anxious, overwhelmed, or confused? Are there cultural barriers or limiting beliefs? What do they care about? How can you change your approach to meet their needs? Do you need to consider layering other support services to approach their case in a more multidisciplinary way? Are your goals reasonable or do they need to be more accommodative and realistic for this situation? Everyone has potential - sometimes you just need to look a little deeper, try a different approach or add in the additional support they need to thrive.
3. Be ready to modify your game plan.
Our patients are not robots - and rehabilitation is not linear. You need to be able to walk in the door, assuming things may not go as planned. The days your patient is painful, stressed or anxious are not the days you are going to get everything done. You need to be flexible and prepared to pivot. This is a skill learned through experience, and I do think it’s one of the hardest things for a student or new grad to understand right off the bat. My advice is to talk with your patient first before making the plan for the day, guide them towards the best choices during your session instead of telling them what you are going to do, and have goals, not plans, for each session.
4. Ask questions, at every visit.
And I’m not talking about ‘How is your pain on a 0-10 or did you do your Home Exercises?’ Read up on motivational interviewing and adapt your questions to your patient’s capability. Looking to get a sense of perceived rate of exertion? Wondering if your balance challenge was hard enough? Yes, there are a million validated pain scales and exertional scales out there, but honestly, who wants to be given a piece of paper with 20 numbers and colors and smiley faces every time they do a new exercise. It’s okay to keep it simple and just ask how it felt - “Was that easy, medium or hard?” “Could you handle another set or need a break?” “How could we make this harder? Want to try closing your eyes or a different surface?” Let your patient make the choices (Bonus - it’s better for neuroplasticity!) - "Anything you want to focus on today?" “We’ve got 15 minutes left - would you rather get outside for a walk or try this new game I brought?” Ask questions that focus on the wins - “What went well this week?” “Tell me one thing you can/will/want to do this week to work towards your goals?” Questions keep your patient engaged and keep you focused on what they truly need.
5. Put the CARE back in your Care Plan.
We all got into this field for the right intentions, but too often, corporate healthcare, big hospitals and practices that prioritize profit over people slowly take this from us. We’re pushed to be more outcome driven, instead of more caring, more efficient instead of empathetic - and this inevitably leads to burnout. If you work somewhere and you feel like your ability to care (not just ‘provide care’) is being stifled, change it. Advocate for a better model. Leave if you need to. Or build something new. Don’t settle for the status quo and remember why you chose this career and take the steps you need to find joy in it again. Bring back the care back to healthcare. Make soft skills the standard, not the exception.
