Thanks for your reflections Sarah. Your confidence will improve with quality mindful practice and mentorship. Like you mentioned in this case the patient became more comfortable the more you did manual therapy. This can sometimes go the opposite direction if you misjudge their symptom irritability, so nice job here matching the techniques with his presentation. Your communication and improved ROM also helped the patients confidence in you. You mentioned feeling like you could have displayed better confidence quicker. Maybe think of it in a different perspective to help with your confidence. Try holding on to the fact that the patient is both appropriate for PT and that your clinical decision making will eventually help him achieve his goals. Understanding if things do not go as planned you have many resources to help create a positive outcome.