Perspectives On ‘Person-Centeredness’ From Neurological Rehabilitation and Critical Theory: Toward a Critical Constellation

This interdisciplinary article addresses the putative gap between person-centeredness and the biomedical model of physiotherapy. We draw both from a primary qualitative study and philosophical praxis to critically evaluate person-centeredness. We suggest that because person-centeredness is difficult to define, conceptual clarification can hardly optimize person-centered practice. Rather, drawing on the Frankfurt school critical theorist, Theodor W. Adorno, we argue it is more helpful to accept its elusiveness as an anti-positivist ‘constellation’ of multiple ideas that critically guide practice. The original purpose of the qualitative investigation was to explore with informants a key question: What matters to them the most in their physiotherapy? The data was generated in 13 semi-structured focused interviews and analyzed using Interpretative Phenomenological Analysis. The findings demonstrate that both evidence-based and person-centered perspectives matter, but according to research they do not always fit together without difficulties. To address this, we suggest that the experiencing and meaning-making embodied person needs to be brought on par with the biomedical object-body of positivist physiotherapy. Person-centeredness recast as a critical constellation (as described in Adorno’s magnum opus Negative Dialectics) works toward this goal because it addresses the narrowness of the biomedical model by drawing widely on human sciences—not excluding biomedicine—as a source of meaningful knowledge. It also draws attention to critical issues that are difficult to research using only biomedical methods. Recasting person-centeredness as a constellation therefore helps to create an awareness among practitioners and students about a variety of issues that might affect person-centeredness in clinical practice.