Fisioterapia en salud mental: recomendaciones para la práctica, la política y el pago

Fisioterapia en salud mental: recomendaciones para la práctica, la política y el pago

Autores/as

  • Dr. Joe Tatta Integrative Pain Science Institute
  • Dr. Jeremy Fletcher
  • Dr. Rose Pignataro
  • Dr. Janet Bezner Texas State University
  • Dr. Annette Willgens Nova Southeastern University
  • Dr. Kerstin Palombaro Widener University
  • Dr. David Morris University of Alabama at Birmingham
  • Dr. Donald Lien University of Alabama Birmingham

DOI:

https://doi.org/10.70205/jptmh.v2i2.15189

Palabras clave:

fisioterapia, salud mental, salud conductual, práctica, política, pago

Resumen

Cuatro de cada cinco personas con desafíos de salud mental y/o conductual presentan una condición física comórbida, y los fisioterapeutas se encuentran con frecuencia con pacientes con necesidades de salud mental y conductual. La depresión es la principal causa de discapacidad, con una prevalencia global de 280 millones de personas. Las personas con depresión también presentan un riesgo elevado de enfermedad cardiovascular, cáncer, enfermedad respiratoria, dolor musculoesquelético, obesidad, enfermedad metabólica y diabetes.  La población  merece una  atención integrada de salud mental y salud física que sea accesible y asequible, y los fisioterapeutas están en una posición única para desempeñar un papel fundamental en la prevención, la detección temprana y la intervención. Objetivos: Este artículo de perspectiva tiene 3 objetivos: 1) proporcionar estrategias prácticas, basadas en la evidencia y aplicables en la práctica clínica, para que los fisioterapeutas manejen estas condiciones; 2) involucrar a los actores académicos y clínicos para actualizar los planes de estudio y ofrecer formación clínica contemporánea a los estudiantes de hoy; y 3) abogar por reformas legislativas y de pago que reflejen la efectividad de la fisioterapia en el abordaje de la salud mental y conductual.  Este artículo contiene tres secciones. La Sección 1 incluye la necesidad de la fisioterapia en salud mental y conductual, el papel del fisioterapeuta como proveedor primario de atención integral, así como los modelos de salud mental y conductual que guían la atención de los fisioterapeutas. La Sección 2 aborda 3 objetivos: (1) cribado y diagnóstico diferencial, mejores prácticas e investigación; (2) educación e intervenciones clínicas para fisioterapeutas que trabajan en salud mental y conductual; y (3) recomendaciones legislativas, de pago y reformas a nivel de sistemas para apoyar a los fisioterapeutas en salud mental y conductual. La Sección 3 incluye recomendaciones y direcciones futuras para que los fisioterapeutas avancen y eleven la profesión en apoyo de las personas a las que servimos.

Biografía del autor/a

Dr. Joe Tatta, Integrative Pain Science Institute

Dr. Joe Tatta, PT, DPT, CNS is a leader in integrative pain care, championing the cause for safe and effective chronic pain treatment. He serves as the CEO of the Integrative Pain Science Institute, a groundbreaking health organization dedicated to transforming pain care through evidence-based treatment, pioneering research, professional development, and free consumer education.

With a career spanning over 25 years, Dr. Tatta has been unwavering in his support for individuals grappling with pain, while also equipping healthcare professionals to enhance their pain management capabilities. His body of pain science research and professional accomplishments extends to the creation of scalable practice models grounded in health behavior change, integrative and lifestyle medicine, and innovative approaches empowering physical therapists to assume the role of primary healthcare providers.

Beyond his role as a speaker and trainer, Dr. Tatta is the best-selling author of three books, the host of the insightful Healing Pain Podcast, and an adjunct professor in the field of physical therapy. His dedication continues to shape the landscape of pain care, inspiring hope and transformation for countless individuals worldwide

Dr. Jeremy Fletcher

Dr. Fletcher is a distinguished physical therapist specializing in program development and primary care physical therapy. With a Doctor of Physical Therapy degree from the University of South Alabama and nearly two decades of clinical experience, Fletcher has made significant contributions to both military and civilian healthcare systems.

Fletcher’s expertise in program development is exemplified through his roles at the Veterans Recovery Resources, where he served as Chief Operations Officer and Director of Community Integration. Here, he successfully planned and executed a $4M SAMSHA grant program, improving access to integrated mental and physical health services for veterans. Additionally, he secured over $6M in funding to establish the nation’s first Veteran-specific Certified Community Behavioral Health Clinic.

In the realm of primary care physical therapy, Fletcher has played a pivotal role. As an Assistant Professor at the University of South Alabama, he developed and taught graduate-level courses, including those focused on primary care in physical therapy for underserved populations. His commitment to integrating physical therapy within primary care settings was further demonstrated during his tenure at Winn Army Community Hospital, where he was among the first embedded physical therapists in a Patient-Centered Medical Home, overseeing the intake and evaluation of injured soldiers.

Currently, Fletcher continues to impact the field as the founder of Community Health Strategies LLC and a practicing physical therapist at Encore Rehabilitation LLC. His work consistently emphasizes holistic and innovative approaches to physical therapy, ensuring optimal outcomes for diverse patient populations.

 

Dr. Rose Pignataro

Dr. Rose M. Pignataro, PT, PhD, DPT is a doctor of physical therapy with more than 30 years of direct patient care experience, including the treatment of chronic pain and associated conditions. In addition to her clinical background, Dr. Pignataro has a PhD in public health, with a strong focus on social and behavioral theory, health promotion and wellness. She is a certified health education specialist (CHES) and certified wound management specialist (CWS). Rose is an Associate Professor and Assistant Chair of Physical Therapy at Emory & Henry College in Marion, Virginia.

Dr. Janet Bezner, Texas State University

Dr. Bezner is a Professor in the Department of Physical Therapy at Texas State University. She received her bachelor’s degree in physical therapy at the University of Texas Medical Branch, her master’s degree from Texas Woman’s University, a PhD in health education from the University of Texas, a DPT degree from Rocky Mountain University of Health Professions, and she is a National Board Certified Health and Wellness Coach. She was Vice President of Education, Governance and Administration at the American Physical Therapy Association (APTA) for 9 years. Bezner has practiced in a variety of health care settings, including hospitals, home health, long-term care, and corporate wellness. Bezner’s research has resulted in 10 book chapters, 25 published articles, 7 grants, and numerous conference presentations on health and wellness-related topics. Bezner served on APTA’s Board of Directors prior to joining its staff and is a recipient of the Lucy Blair Service Award and is a Catherine Worthingham Fellow of the APTA. She is an experienced speaker on topics related to health promotion and wellness, leadership, personal development, and strategic planning. Dr. Bezner has been facilitating strategic planning meetings and providing leadership training for non-profit organizations, academic units, and others for over 20 years.

Dr. Annette Willgens, Nova Southeastern University

Dr. Annette Willgens is best known for her research and course development on Mindful Clinical Mentoring and Mindful Stress Management for the Healthcare Professional.  She is a pioneer in using mindfulness-based approaches to address PT student stress, burnout, and practitioner self-compassion. She is a professor, clinician, and researcher. She earned her certificate in mindfulness at the University of California, School of Medicine, in 2012. She has designed and delivered workshops and courses in mindful clinical practice at the undergraduate and graduate levels. She earned her Bachelor of Science in Physical Therapy at Ithaca College, her Master of Education at New York University, and her Doctor of Education at Northcentral University. She holds additional certifications as a registered yoga teacher (RYT-200), a qualitative researcher (Nova Southeastern University), a trauma-informed care provider (Temple University), a clinical educator (American Physical Therapy Association), and a clinical specialist (ABPTS 2008-2018). She is a pediatric practitioner of over 30 years and continues to practice at Children’s Hospital of Philadelphia.

Dr. Kerstin Palombaro, Widener University

I received my Bachelor of Science degree in psychology from St. Joseph's University (Philadelphia), my Master of Science degree in physical therapy from Columbia University (New York), and my Doctor of Philosophy in physical therapy from Temple University (Philadelphia). My clinical practice as a Pennsylvania-license physical therapist focuses on holistic, lifestyle medicine interventions for community-dwelling older adults, with an emphasis on diagnoses of osteoporosis, frailty and chronic pain conditions. I am BoneFit certified through Osteoporosis Canada and am certified in the LSVT-BIG program for patients with Parkinson's Disease.

I serve as Program Director for the PhD in Health Professions Education at Widener University. I enjoy mentoring the doctoral students as they develop their health professions research, lectures, and courses. I bring my passion for community engagement into teaching the students in this program, through discussions of ethical community-based global learning and research. I am also privileged to teach in the Doctor of Physical Therapy program, sharing best practices for treating the older adult client and my love of research methods

Dr. David Morris, University of Alabama at Birmingham

David M. Morris, PT, PhD, FAPTA is Professor and Chair of the Department of Physical Therapy at the University of Alabama at Birmingham where, since 1991, he has taught in the entry-level Doctor of Physical Therapy, Doctor of Science in Physical Therapy and PhD in Rehabilitation Science degree programs. Morris earned a BS in physical therapy from the University of North Carolina, Chapel Hill; a MS in physical therapy education and a PhD in health education/promotion from the University of Alabama at Birmingham. He is also a Credentialed Fellowship Graduate from the APTA Education Leadership Institute Fellowship. He has been a member of the UAB Constraint Induced (CI) Therapy Research Group since 1994 and has participated in multiple research projects aimed at developing the approach and examining its influence on extremity use following stroke and other neurologic disorders. He is Training Coordinator for the UAB Training for CI Therapy program and conducts CI therapy training programs for rehabilitation professionals worldwide. He has held multiple leadership roles in several APTA components including being a member of the founding Executive Committee and serving two terms as President for the APTA Aquatic PT Section. He also served three terms as Vice President and two terms as President for the Alabama Chapter of the APTA. He has authored and/or co-authored numerous peer-reviewed manuscripts and book chapters concerning the topics of aquatic physical therapy, neurologic physical therapy and the PTs role in health promotion, wellness and prevention. He is recipient of multiple awards including the 2009 APTA Lucy Blair Service Award, the 2012 APTA Legislative Commitment Award, the 2012 Marilyn Gossman Award for Professionalism in PT and the 2016 Leadership Award from the Alabama Chapter of the APTA, and the 2017 Joseph F. Volker Outstanding Faculty Award from the UAB School of Health Professions. In 2017, he received the APTA Catherine Worthingham Fellow Award.

Dr. Donald Lien, University of Alabama Birmingham

Donald H. Lein Jr., PT, PhD is a Professor, the Bergman/Pinkston Endowed Professor in Physical Therapy, Director of the Graduate Certificate in Primary Care Physical Therapy for Underserved Populations, and the Director of Continuing Education and Community Outreach in the Department of Physical Therapy at the University of Alabama at Birmingham (UAB). He continues to practice part time in the UAB Osteoporosis Prevention and Treatment Center at the Kirklin Clinic. His research interests include developing and implementing physical therapy interventions to improve the care of individuals with chronic conditions, exploring the role of physical therapists in providing health promotion and education while providing typical physical therapy services, and developing and testing educational strategies to enhance Doctor of Physical Therapy education. He has a special interest in delivering primary care physical therapy to underserved populations and marginalized communities. He has published manuscripts in peer -review journals and presented nationally and internationally concerning his research interests. He has served as Delegate, Chief Delegate, and President of APTA Alabama. He has received several awards for excellence in patient care at UAB, the 2014 Marilyn Gossman Award for Professionalism in Physical Therapy, the Fall 2017 UAB Disability Support Services Outstanding Recognition Award, and the 2024 UAB School of Health Professions Excellence in Service Award.

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Publicado

2025-12-31 — Actualizado el 2026-02-23

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Cómo citar

Tatta, J., Fletcher, J., Pignataro, R., Bezner, J., Willgens, A., Palombaro, K., … Lien, D. (2026). Fisioterapia en salud mental: recomendaciones para la práctica, la política y el pago. Revista De Fisioterapia En Salud Mental, 2(2), 46–62. https://doi.org/10.70205/jptmh.v2i2.15189 (Original work published 31 de diciembre de 2025)

Número

Vol. 2 Núm. 2 (2025): Revista de Fisioterapia en Salud Mental

Sección

Perspectiva

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Licencia

Derechos de autor 2025 Revista de Fisioterapia en Salud Mental

Creative Commons License

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.

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