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Exploring the Benefits of NDIS Physiotherapy for Psychosocial Disability

Tristan Favaloro

Psychosocial disability is a term used to describe a disability that may arise from a mental health issue. Not every individual with a mental health issue will have a psychosocial disability, but for those who do, the effects can be severe, persistent and impact their recovery. Individuals with a psychosocial disabilities can experience impairments in both their physical and mental functioning. In instances where the psychosocial disability results in physical impairments, it is more easily understood how Physiotherapy can offer help. However, Physiotherapy interventions can also be beneficial in managing mental health impairments, as exercise, relaxation techniques and manual therapy have been demonstrated to enhance mood and reduce anxiety levels or increase access and participation in the community

What are the most common types of psychosocial disability?

The most common Psychosocial disabilities are:

  • Schizophrenia

  • Anxiety Disorders such as Post-Traumatic Stress Disorder, OCD, Agoraphobia and social phobia

  • Mood disorders such as major or dysthymic depression and bipolar.

Psychosocial Disability statistics of those on the NDIS

As of 31 December 2021, people with a psychosocial disability formed the third largest primary disability group (53,123 people) among NDIS participants. With 1 in 2 (50.9%) of NDIS participants with Psychosocial Disabilities having Schizophrenia as their primary diagnosis.

The NDIS and the Psychosocial Disability Recovery-Oriented Framework

One of the main goals of the NDIA is that the "NDIA wants all people with psychosocial disability in the NDIS to be supported in their personal recovery and to live a life that has meaning for them. They will have access to supports in accordance to the NDIS Act that enable social and economic participation."

As such the NDIA's Recovery Framework aims to improve the NDIS experience for participants, their families and carers by:

  • Setting out principles to guide the NDIS in its understanding of, and improved responses to, psychosocial disability

  • applying to all NDIS participants living with psychosocial disability, recognising that many people living with psychosocial disability also live with other disabilities

  • applying to NDIA staff, partner organisations, and NDIS funded services

The six guiding principles of the Recovery Framework are:

  1. Supporting personal recovery

  2. Valuing lived experience

  3. NDIS and mental health services working together

  4. Supporting informed decision making

  5. Being responsive to the episodic and fluctuating nature of psychosocial disability

  6. A stronger NDIS recovery-oriented and trauma informed workforce.

See the NDIA’s PDF on the Psychosocial Disability Recovery Oriented Framework for further details.

Functional Capacity and the NDIS

The NDIS may provide participants with physiotherapy support to improve their functional capacity. Functional capacity refers to the capability of performing tasks in various daily life situations. It is highly personalised and can vary significantly from person to person. Some individuals may struggle to execute certain tasks (reduced functional capacity). In contrast, others may not be able to engage in or finish a task effectively at all (significantly reduced functional capacity).

One of the eligibility criteria for a prospective participant for the NDIS funding is assessing their Functional Capacity against six life skill areas.

  1. Social Interaction

  2. Self-Management

  3. Self-Care

  4. Learning

  5. Communication

  6. Mobility

How can psychosocial disabilities impact physical health and function?

As Psychosocial Disabilities is a broad term, many people with psychosocial disabilities may experience a varying severity in the reduction of functional capacity and impairments of their physical health due to their primary disability, their other comorbidities and their risk of developing secondary health conditions, which may include:

  • Mobility and movement issues

  • Reduced functional capacity and endurance

  • Decreased participation and practice in activities of daily living and sports

  • Weight gain and muscle loss due to sedentary behaviour and limited participation in activities.

  • Cardiovascular disease, diabetes and obesity

  • Experience pain more frequently and at a higher degree than the general population.

How do physiotherapists assess and manage psychosocial disability?

Physiotherapists use a variety of approaches to assess and manage psychosocial disability. The first step of an NDIS physiotherapist is to understand the person's background, medical history, NDIS goals, and any physical or psychological limitations. Common physiotherapy assessment techniques include patient history and physical examination, gait analysis, functional assessment, and musculoskeletal assessment. From there, physiotherapists will develop an individualized treatment plan that aims to improve the participant’s physical and mental health.

How can physiotherapy help those with psychosocial Disabilities?

Physiotherapy can play a crucial role in managing psychosocial disability. It can help individuals with physical and emotional impairments to become more independent through tailored exercise programmes and therapeutic activities. Physiotherapists can also provide education, advice and emotional support to people with mental health issues, helping them to cope with their disability. Many people who have suffered a stroke or traumatic brain injury may also develop a psychosocial disability after their acquired brain injury. In these cases, physiotherapy may help to assist both the physical and psychosocial disability, helping them improve their quality of life. In addition, physiotherapy can help people with psychosocial disabilities to develop strategies to manage their disability, such as pacing and relaxation techniques, helping them to better manage their condition and lead a more fulfilling life. Ultimately, physiotherapy aims to address the participant's psychosocial disability in a holistic way to help them achieve their highest level of physical and mental well-being.

What may Physiotherapy involve?

Depending on the psychosocial disability and the severity of the functional impairments, physiotherapy may involve:

  • Exercise and Home Exercise Programs to improve their strength, coordination, balance, posture and endurance.

  • Mobility retraining

  • Relaxation techniques such as deep breathing and progressive muscle relaxation

  • Manual therapy and education to reduce pain

  • Advice and education to family and carers

  • Learning self-care strategies through improvements in posture, task practice and movement.

  • Developing self-awareness, self-confidence and self-esteem in activities of daily living

What other NDIS services does Realisation Healthcare offer?

Realisation Healthcare also offers a range of Allied Health services, including Occupational Therapy, Dietetics and Exercise Physiology.

What makes Realisation Healthcare's physiotherapy different?

At Realisation Healthcare, we are dedicated to providing top-notch physiotherapy services to individuals with intellectual disabilities, neurological conditions, and mental health disabilities. We are NDIS registered and are specialists in these fields.

At Realisation Healthcare, we get to know you as an individual and how your disability impacts your quality of life, function and well-being. We use the Realisation Healthcare Approach to understand everything about you, what is important to you, and your goals and aspirations and combine it with our tailored and individualised physiotherapy services to get you to be able to live life to the fullest. Our ultimate goal is to help our clients realise their full potential and live life to the fullest. With the Realisation Healthcare approach, you can be sure that you will receive compassionate and effective care designed to meet your unique needs and help you achieve the best possible outcome.

We respond to all queries and questions within 24 hours, and bookings can be made within a week. Contact us today through phone, email or for a casual chat over messenger to see how we can help you. You can also fill out the referral form by clicking on the button below.



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References:

Australian Government Department of Health and Aged Care. (2022, November 15). Collection of evidence to inform Australia's physical activity and sedentary behaviour guidelines. Australian Government Department of Health and Aged Care. Retrieved February 12, 2023, from https://www.health.gov.au/resources/collections/collection-of-evidence-to-inform-australias-physical-activity-and-sedentary-behaviour-guidelines

Aylett, E., Small, N., & Bower, P. (2018). Exercise in the treatment of clinical anxiety in general practice - a systematic review and meta-analysis. BMC health services research, 18(1), 559. https://doi.org/10.1186/s12913-018-3313-5

Greer, T. L., Trombello, J. M., Rethorst, C. D., Carmody, T. J., Jha, M. K., Liao, A., Grannemann, B. D., Chambliss, H. O., Church, T. S., & Trivedi, M. H. (2016). IMPROVEMENTS IN PSYCHOSOCIAL FUNCTIONING AND HEALTH-RELATED QUALITY OF LIFE FOLLOWING EXERCISE AUGMENTATION IN PATIENTS WITH TREATMENT RESPONSE BUT NONREMITTED MAJOR DEPRESSIVE DISORDER: RESULTS FROM THE TREAD STUDY. Depression and anxiety, 33(9), 870–881. https://doi.org/10.1002/da.22521

National Disability Insurance Scheme. (n.d.). Retrieved February 12, 2023, from https://www.ndis.gov.au/media/3957/download?attachment

Ohrnberger, Fichera, & Sutton. (2017, November 8). The relationship between physical and mental health: A mediation analysis. Social Science & Medicine. Retrieved February 12, 2023, from https://www.sciencedirect.com/science/article/pii/S0277953617306639

Psychosocial disability support - mental health - AIHW. Australian Institute of Health and Welfare. (n.d.). Retrieved February 12, 2023, from https://www.aihw.gov.au/mental-health/topic-areas/psychosocial-disability-support#:~:text=As%20at%2031%20December%202021%2C%20among%20NDIS%20active%20participants%20with,in%20Western%20Australia%20(167.2).


Frequently Asked Questions

What strategies can be used to facilitate physiotherapy for those with a psychosocial disability?

Physiotherapy can be a valuable tool for those with psychosocial disabilities, as physical activity and improvements in function can help reduce mental health symptoms and improve overall well-being. There are several strategies that can be used to facilitate physiotherapy for those with psychosocial disabilities.

Firstly, it is important to provide a supportive environment. This includes creating a safe and comfortable space, as well as considering any environmental factors that may be triggering for the individual. It is also important to acknowledge any emotional responses that may arise during physiotherapy sessions.

Secondly, it can be beneficial to utilise a stepped-care approach. This involves starting with simple activities and gradually increasing the intensity and complexity of the exercises over time. It is important to ensure that the individual feels comfortable and supported throughout the process.

Thirdly, involve family members, carers, and other professionals in the physiotherapy planning process. This can help ensure that the individual’s physiotherapy is tailored to their individual needs and abilities.

Finally, incorporate strategies to help the individual build self-efficacy. This can involve providing positive reinforcement, encouragement, and setting realistic goals.

Following these strategies makes it possible to provide effective physiotherapy for those with psychosocial disabilities.