After discussing the benefits of therapy and the risks of refusing intervention, a patient declines physical therapy. What is the MOST appropriate response?

• A. Respect the patient's decision to decline the therapy
• B. Continue discussions with the patient on why therapy is the best option
• C. Begin treatment with a very easy exercise
• D. Refer the patient to another therapist who may be able to establish a better rapport

Answer: (B)

Promoting informed consent through ongoing discussion is essential when a patient declines after hearing the benefits and risks. The clinician’s job is to explore the patient’s reasons for refusal, clarify any misunderstandings, and reinforce why therapy is recommended, while respecting the patient’s autonomy. This approach helps ensure the patient is truly informed and can make a decision aligned with their values and goals. It also provides an opportunity to address barriers—such as fears, time, transportation, or doubts about effectiveness—and to discuss feasible alternatives or a plan for re-discussion.

Starting treatment without consent would override the patient’s choices and undermine trust. While referring to another therapist might be useful if rapport is a significant barrier, the immediate best step is to continue the conversation with the same patient to support an informed decision. Document the discussion and offer to revisit the decision later or adjust the plan to fit the patient’s preferences.