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88 m a s s a g e & b o d y wo r k j a n u a r y/ fe b r u a r y 2 0 2 1 How Client Expectations Shape Results A Conversation with Manual Therapy Researcher Mark Bishop, PhD BY TIL LUCHAU AND WHITNEY LOWE Editor's Note: Til Luchau and Whitney Lowe recently spoke with manual therapist, physiotherapist, and researcher Mark Bishop about his fascinating research into how clients' expectations influence treatment results. His research shows that clients who think treatment will help often benefit far more than those who don't expect much relief. Key excerpts from their longer conversation (which took place on Whitney and Til's The Thinking Practitioner podcast) have been edited here for clarity and context. Til Luchau: Mark, you are a physiotherapist with more than 30 years of clinical and research experience in the rehabilitation of musculoskeletal pain disorders. Your impressive bio says your work has "focused on the mechanisms underpinning the effectiveness of conservative interventions for pain, especially in manual therapy and exercise." 1 I met you at the San Diego Pain Summit in 2019, where you said some pretty interesting things about client expectations, treatment choices, and treatment results. Mark Bishop: Yes, the thing that fascinated me clinically was that there were people I was not able to help. This motivated me to start studying manual therapies, which techniques I should use for which people, and when I should apply those. MENTAL OR PHYSICAL? MB: We had the good fortune to collaborate with a group of clinical and health psychologists. At that time, I had a very dualistic view that there were psychological factors and [separate] neurophysiological factors. It was a psychologist who really encouraged us to think a little bit differently. He said that if you thought anything, part of technique | THE SOMATIC EDGE