PROCESS-BASED SPECIALIST IN MOVEMENT & PAIN
A certification program that was created to help clinicians develop competence, critical thinking, and comfort in the use of a biopsychosocial process-based framework called the Human Rehabilitation Framework (HRF)™ for the care of clients/patients who struggle with pain and movement. This coursework is transdisciplinary and transdiagnostic in nature and designed for:
Physical Therapists, Athletic Trainers, Occupational Therapists, Chiropractors, Physical and Occupational Therapist Assistants, Massage Therapists, Osteopaths, and Physicians.
The PSMP is an online and live hybrid program which can be flexibly completed over the course of 1 to 5 years. This course work is designed to help participants re-conceptualize movement, manual therapy, and pain science clinical understanding and interventions to current standards of science-based evidence, while simultaneously building up communication and behavior modification skills to help clinicians better work with clients and patients who struggle with movement and pain. In this process, clinicians are introduced to a biopsychosocial process-based framework called the Human Rehabilitation Framework (HRF)™ to help them take on uncertainty and complexity with increased comfort. This coursework is combined with a portfolio review to encourage the clinician to incorporate different science-based perspectives from other educators within the domains of Movement, Manual Therapy, Communication, and Behavior. The program finishes with a capstone providing opportunities for both conceptual and experiential integration.
“He does a wonderful job of breaking down a complex topic into manageable parts using current evidence and clinical examples. The combination of lecture, lab, and a clearly passionate presenter helped the time to fly by over the course of two days. I look forward to future offerings by Leonard and Dynamic Principles!”
– KATHLEEN WALWORTH PT, DPT, GCS, CEEAA
“I attended Leonard’s course “Pain Science, Movement, and Manual Therapy for Rehabilitation Professionals.” The course was excellent, and I walked away with ideas to incorporate a biopsychosocial approach to movement and manual therapy in my practice. My goal is to have ALL of my staff therapists attend a future courses offered by Dynamic Principles.”
– LINDSAY VERTALKA PT, MSPT
I would highly recommend any course Leonard and Dynamic Principles has to offer. I took the Pain Science, Movement, and Manual Therapy course this past fall, and was introduced to a whole new way to approach my patient care and make me a better overall athletic trainer. Leonard’s passion and excitement helped with understanding the complex topics.
– CRAIG PLONKA AT, ATC
I took the Pain Science, Movement and Manual Therapy course this weekend presented by Leonard and Dynamic Principles. I would definitely recommend this course. He takes a very complex topic and breaks it down in a way that you can understand. This course has provided me with more options to use to treat my patients and with the ability to incorporate this information into treatments when I return to the clinic tomorrow. This course has really intrigued me and has me excited to delve more into this treatment approach. I look forward to attending more courses offered by Leonard and Dynamic Principles.
– CHRIS WILLIS PTA
Leonard does such an amazing job. He takes what can be a very complex topic and breaks it down providing current evidence-based literature and examples. He also uses several analogies and illustrations to help. If you have the opportunity to learn under Leonard, or attend a conference/class, I would highly recommend it. You won’t be disappointed.
– TYLER FINCH PT, DPT
What is the Human Rehabilitation Framework (HRF?)™
Why choose the PSMP?
The PSMP was designed to bridge the gap toward application and clinical integration of the biopsychosocial model, pain science, and contemporary movement and manual therapy science. Significant emphasis on working with uncertainty and complexity is built into the coursework. Transitioning clinicians from diagnostic/protocol interventional approach to a process-based approach is guided through the Human Rehabilitation Framework (HRF).™ The PSMP will introduce several firsts in the available movement and pain certification market. It will be the first movement, rehabilitation, manual therapy, or pain oriented certification to:
In addition, since the PSMP will continue to evolve on an ongoing basis to keep up with the current scientific evidence and best practice, all participants and certified providers will have the opportunity to access to advances in the course work to ensure they are practicing in the most current supported scientific evidence.
What do you mean by Process-Based Approach?
Process-based therapy is most commonly recognized in psychological clinical practice, in particular Acceptance and Commitment Therapy (ACT), but the underlying premise of engaging in biopsychosocial processes during clinical practice is transdisciplinary and transdiagnostic in nature, in particular with movement and pain. Traditional clinical categorization of patient/client presentations provides a cluster of symptoms that fit a syndrome for which a protocol would be initiated. However, this approach is recognized as extremely limited when it comes to the complexity of pain, movement, increasingly convergent diagnoses, and psychological and social factors. A patient may present with multiple diagnosis for chronic low back pain, right shoulder pain, left knee pain, depression, anxiety, and headache diagnoses that would yield time and practical consideration competing interests, excessive utilization, excessive interventions, and a plan of care which would not be adherable by most patients if addressed by a protocol approach. Even a simple ankle sprain is more than the ankle for an athlete in the middle of their season. Yet, these presentations are common and often result in emphasis on a single factor, domain, or diagnosis without recognition of overlapping biopyschosocial processes in such presentations. Conversely, a process-based approach that is transdiagnostic engages in biopsychosocial processes that help facilitate change for client with multiple concordant diagnoses with lower utilization, increased patient autonomy and agency, and sustainable strategies in the long term to improve patient quality of life. The PSMP trains clinicians in a process-based approach to movement and pain with the availability of clinical mentorship during and after completion of the program.
What is the Biopsychosocial model?
The biopsychosocial model provides a framework which explores the interplay of biology, psychology, and sociology in human health and illness. It was developed by George Engel in 1977 as an effort to address the shortcomings of the biomedical model for treatment of illness and addressing human health. The biomedical model exclusively identifies illness as the sum of purely biological factors with the exclusion of psychological and social factors, a stance which is incompatible with current scientific evidence for the treatment of movement and pain problems. Psychosocial factors are predominant predictors of health outcomes and disability trajectory, and human health cannot be addressed without inclusion of these factors. In recognition of this understanding, the World Health Organization (WHO) first advised that all healthcare providers adopt this model in 1987 and later developed the International Classification of Function (ICF) with the biopsychosocial model as the foundation. In recent years, the adoption of the biopsychosocial model has expanded to include sports medicine: Organizations ranging from the International Olympic Committee (IOC), the National Collegiate Athletic Association (NCAA), and US Military have made the stance that athletes in pain, should be treated by sports medicine clinicians who have a thorough understanding of the biopsychosocial model. Specific to physical therapy, the IOC recommends that physical therapists who treat athletes should be trained to “identify and address inaccurate conceptualizations of pain and injury plus psychosocial and contextual influences on pain” and be able to educate “the athlete regarding the role of the central nervous system in pain, especially in chronic pain“.
Despite world-wide and USA healthcare recognition of gaps in this knowledge, acceptance and integration of BPS-based models for clinical practice is poor and rare in both private practice and hospital-based systems. This has been consistent across multiple healthcare disciplines, often with concerns of few incentives for adoption of the BPS model with current reimbursement models, the impact of the BPS model on workload, and inadequate resource availability for developing competence in BPS care serving as significant limiters to adoption. The PSMP was developed as an effort to address these barriers and many other challenges regarding the adoption of the BPS model in the treatment of individuals struggling with movement and pain problems.
What is the difference between transdisciplinary and multidisciplinary?
Multidisciplinary approaches have shown potential to be beneficial for individuals struggling with pain. However, stand-alone intensive multidisciplinary biopsychosocial pain programs have a number of logistic, financial, and implementation challenges. Current healthcare climate (organizational factors, reimbursement, etc.) further decrease the likelihood of scaling stand alone centers to meet the needs of the world-wide pain epidemic. The PSMP proposes an additional model to a traditional standalone multidisciplinary approach by shifting the emphasis from multiple single disciplines exclusively working in their specific domains, to a transdisciplinary model of practice across providers. Utilizing a transdisciplinary perspective allows for individual providers to have cross training with key aspects of pain treatment traditionally provided by other disciplines. By doing so, this would permit clinics with fewer available internal clinical disciplines to work within their network and community to allow for flexible integration of other disciplines on an as-needed basis to meet both the practical clinical and patient needs. This is particularly important when it comes to determining the appropriateness of the number of disciplines needed to meet the needs of the patient. Concurrent to this increased autonomy, this model will still function within new and existing multidisciplinary environments with the potential to decrease and address inefficiencies and gaps in care.
Will my course qualify for the portfolio review?
Our certification board will assess course qualification based on the scientific rigor involved in the development of a course and the congruency presented in the course between available scientific evidence and clinical practice. Below are generic examples of courses which would likely meet portfolio review approval.
Movement (Examples: Science-based exercise prescription, Graded Motor Imagery, Graded Activity and Exposure, and Loading Capacity related coursework)
Manual Therapy (Examples: Neurodynamics, Dermoneuromodulation, and other science-based manual therapy courses)
Communication (Examples: Educational Strategies courses: Pain Neuroscience education, and narrative approaches)
Behavior (Examples: ACT/DBT/CBT/Motivation Interviewing coursework)
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