Absent nature, absent bodies: towards whole-person ontology for physiotherapy

Historically, physiotherapy has utilized biomedical models of health that originated from the era of the Industrial Revolution, where discipline and mechanical understandings of the body were prevalent. Other models of health have slowly developed in line with societal changes, such as the biopsychosocial model, and person-centred and psychologically informed practice, but these models are being used in a disparate manner, and the consistent fallback model is the biomedical. Further, the interaction of humans with nature is not explicitly discussed within healthcare, and this can lead to an oversight of how the natural world and environment impact upon wellbeing. However, recent strides have been made within the social prescribing movement. This conceptual paper discusses the use of dialectical critical realism to offer theoretical solutions to help shift healthcare practice from reductionism/naïve realism to one which is more ontologically sound and inclusive of the natural world.