The Art of Negotiation in Physiotherapy: A Guide to Engaging Resistant Client

As physiotherapists, we are often confronted with the challenge of working with resistant clients. Rehabilitation can be a physically and emotionally taxing journey for both the clinician and the client. Striving for the best outcomes makes effective negotiation essential. Yet, it’s easy to fall into certain pitfalls that can jeopardise a successful and enduring relationship with our clients.

Understanding the Adversarial Trap

In many negotiations, both parties view each other as adversaries. It’s a tug-of-war where each side aims to gain as much as possible. You want client commitment, and they to feel in control of the treatment process. But it’s important to differentiate between wants and needs. While you may want a client to commit to a particular treatment plan, their needs may demand something more flexible and lifestyle-compatible.

The Risk of Overcommitment

If you manage to get everything you want in terms of client commitment, consider the long-term implications. A client who feels overwhelmed may discontinue treatment prematurely, impacting their health, your professional relationship and your reputation. The goal should be to create a win-win situation, a setting where the treatment aligns with what is genuinely beneficial for the client both in the short and long term.

Shifting from a Self-Centric to a Client-Centric Approach

It’s easy to get caught up in professional goals and objectives. However, if you’re not thinking about how an agreement might affect the client, your approach is essentially selfish. To engage resistant clients effectively, your own objectives must take a back seat. The focus should be on what is important to the client and understanding what drives their behaviours and decisions.

Cultivating a Collaborative Mindset

The cornerstone of effective negotiation lies in adopting a collaborative mindset. It is not just about figuring out how to get what you want but rather understanding the client’s perspective and make them feel good about committing to actions they know they can implement. A collaborative approach enables you to find common ground, which is often the first step toward meaningful engagement.

Practical Steps to Implement a Collaborative Mindset

  • Be Curious: Listen to what the client is saying beyond the words they are using. Ask open-ended questions to explore the client’s viewpoints and perspectives.
  • Be Flexible: While you may have a specific treatment plan in mind, be prepared to adjust it based on the client’s feedback and needs.
  • Show Empathy: Recognise and validate the challenges and concerns your client is experiencing. This can go a long way in building trust.
  • Define Shared Goals: Ensure that both parties are aligned on what successful treatment looks like.
  • Communicate Clearly: Be clear about what you can offer and what you can’t. Transparency is key in any negotiation.
  • Avoid Control: Let go of the need to control every aspect of the negotiation. Allow your client the space to express their needs and concerns.
  • Aim for Mutual Satisfaction: Strive for an agreement that is not just beneficial to you, but also to your client. A satisfied client is a committed client.


Negotiation is a skill, and like any skill, it requires practice and a willingness to evolve. A critical part of this evolution is shifting from a mindset focused on ‘winning’ to one of collaboration and curiosity. 

Only by setting aside your own needs to genuinely focus on those of your clients, can you hope to engage even the most resistant of them successfully. It is not merely a strategy but a philosophy that fosters better understanding, stronger relationships, and ultimately, improved outcomes for your clients.

What I offer you and your staff?

Skills practice and reflection will be the cornerstone of my training. I am available for both in person and limited Zoom PD for your group.

If you have a staff member who is struggling to keep new patients or confidently present treatment plans, you might be interested in one-on-one coaching for him/her. 

If you would like to engage me to work with your staff or coach a member of your team, click here so that you can schedule a time to discuss your specific training needs.

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