A Biopsychosocial Framework for Clinical Practice

Dates: 1 - 2 June 2019
Course leaders: Dr Hilary Abbey, Dr Cindy McIntyre, Dr Jerry Draper-Rodi
Cost: £218 - £270


About the course

Have you ever worked with patients whose symptoms don't seem to fit the models and theories you normally use in osteopathic practice? Have you ever worked with complex clinical cases without understanding why, or how, patients think you are helping them? Have you ever felt that your treatment isn't as effective as you'd like?

This two-day course explores advances in understanding the biopsychosocial model of healthcare and ways of integrating physical and psychosocial care more effectively in clinical practice. Participants will be introduced to current theories and research demonstrating best practices and innovative ways of managing patients with non-specific musculoskeletal symptoms. Two workshops will focus on reflective practice and mindfulness-informed interventions and align with Standards 1 and 2 of the GOsC's new CPD scheme (communication and patient partnership; knowledge, skills and performance; and professionalism).

Summary of Osteopathic Practice Standards (updated) covered in this course

  • A) Communication and patient partnership - A1, A2, A3, A5, A7
  • B) Knowledge, skills and performance - B1, B2, B3, B4
  • D) Professionalism - D1, D2, D3, D8, D9

Communication and consent

Communication and consent will be integrated into the practical activities in the workshop on mindfulness-informed approaches. Specific communication issues will include patient-centred approaches to exploring an individual's beliefs about pain with the aim of increasing awareness of the consequences of reactions to pain in daily life. The psychological and mindfulness-informed approaches of Acceptance and Commitment Therapy (ACT) require patients to be willing to explore thoughts, feelings and physical experiences of discomfort, which can be distressing, so the workshop will focus on developing methods for requesting consent as an ongoing process. It is estimated that the workshop will involve approximately 1-2 hours of material directly relating to communication and consent.

Learning outcomes

  • To explore current theories about non-specific musculoskeletal pain
  • To identify key prognostic factors in non-specific musculoskeletal pain
  • To explore how to manage key prognostic factors in osteopathic practice
  • To understand how to enhance a good therapeutic alliance
  • To understand the value of reflecting on your own practice
  • To gain experience in reflective practice
  • To experience how psychological and mindfulness-informed interventions from Acceptance and Commitment Therapy can help some patients to manage their own symptoms more effectively

Course suitability

Any manual therapists managing patients in pain.


Course schedule

Day One

09:00-09:30 Registration

09:30-10:15 Pain and the biopsychosocial model (JDR)

10:15-11:00 Pain mechanisms (JDR)

11:00-11:15 Coffee break

11:15-12:00 Psychosocial factors: which ones? How to assess them? (JDR)

12:00-12:45 Exploration of potential management options of psychosocial factors (JDR)

12:45-13:45 Lunch (included)

13:45-14:15 Types of reflective practice (CM)

14:15-14:30 Momentary reflective practice, increased awareness and patient care (CM)

14:30-15:45 Structuring a reflection (CM)

15:45-16:00 Tea break

16:00-17:00 Critical reflection (CM)

17:00-17:30 Foundation of Day 2 (HA)

Day Two

09:30-10:30 Therapeutic alliance (JDR)

10:30-11:15 Patient education & communication (JDR)

11:15-11:30 Coffee break

11:30-12:15 Expanding our awareness as practitioners (therapeutic alliance and willingness) (HA)

12:15-13:15 Lunch (included)

13:15-14:00 Exploring the patient's experience of pain (biopsychosocial case history taking) (HA)

14:00-14:45 Learning from patients' reactions to pain and movement (expanding assessment routines) (HA)

14:45-15:30 Developing patient self-care (using the psychosocial effects of osteopathic treatment) (HA)

15:30-15:45 Tea break

15:45-17:15 Reflective workshop (CM)

17:15-17:30 Q&A

Participants are asked to come in comfortable clothing on Day 2 ready for practical body work (but undressing will be optional).


Recommended pre-reading

  • Harris R. (2009). “Mindfulness without meditation.” HCPJ: 21-24
  • Draper-Rodi, Jerry, Steven Vogel, and Annette Bishop. (2018). "Identification of prognostic factors and assessment methods on the evaluation of non-specific low back pain in a biopsychosocial environment: A scoping review." International Journal of Osteopathic Medicine.
  • Carnes, D., Mars, T., Plunkett, A., Nanke, L., Abbey, H. (2017). A mixed methods evaluation of a third wave cognitive behavioural therapy and osteopathic treatment programme for chronic pain in primary care (OsteoMAP). International Journal of Osteopathic Medicine.


About the course leaders

Dr Hilary Abbey D.Prof (Ost), MSc, PGDip, PGCert, DO, FHEA

Hilary Abbey qualified as an osteopath in 1979 and currently works full time at the UCO, where she is Head of Research. She was the Project Leader for the Osteopathy, Mindfulness and Acceptance-based Programme (OsteoMAP) for patients with persistent musculoskeletal pain and has a long-standing interest in psychological and social aspects of healthcare. In 2015, Hilary was amongst the first cohort selected for the Osteopathic Leadership Programme, in collaboration with the Open University. She completed a Professional Doctorate involving the integration of psychological acceptance-based and mindfulness interventions into osteopathic practices. Her research interests include biopsychosocial models of healthcare, pain management, relationships between embodiment, touch, awareness and interoception, and integrating mindfulness and mindful movement practices with manual therapy.

Selected publications:

  • Thomson, O., Abbey, H. (2017) Your paradigm or mine? Navigating the varied landscapes of osteopathic practice, research and education. International Journal of Osteopathic Medicine, 24:1-2
  • Carnes, D., Mars, T., Plunkett, A., Nanke, L., Abbey, H. (2017). A mixed methods evaluation of a third wave cognitive behavioural therapy and osteopathic treatment programme for chronic pain in primary care (OsteoMAP). International Journal of Osteopathic Medicine
  • Nanke, L., Abbey, H. (2017). Developing a new approach to persistent pain management in osteopathic practice. Stage 1: a feasibility study for a group course. International Journal of Osteopathic Medicine, 26, 10-17.
  • Nanke L. and Abbey H., (2015). A brief introduction to Mindfulness. The Osteopathy Today, July/August 2015, 47-48
  • Abbey, H. (2015). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. International Journal of Osteopathic Medicine, 18(3), 239-240
  • Abbey, H., & Nanke, L. (2014). Developing OsteoMAP: A new programme to expand the scope of care for patients with persistent pain. Bone & Joint Journal, 96-B:(SUPP 4) 44
  • Abbey, H., & Nanke, L. (2013). Developing a chronic pain self-management clinic at the British School of Osteopathy: Quantitative pilot study results. International Journal of Osteopathic Medicine, 16(1), e11–e12.
  • Esteves, J. E., Wheatley, L., Mayall, C., & Abbey, H. (2013). Emotional processing and its relationship to chronic low back pain: Results from a case-control study. Manual Therapy, 18(6), 541–546.
  • Mars, T. S., & Abbey, H. (2010). Mindfulness meditation practise as a healthcare intervention: A systematic review. International Journal of Osteopathic Medicine, 13(2), 56–66.


Dr Cindy McIntyre is Honorary Research Fellow at UCO.

Cindy was awarded her Osteopathic Professional Doctorate in 2016 after conducting an innovative piece of research on clinical reasoning, palpation and reflective practice entitled 'Osteopathic Clinical Reasoning: An Ethnographic Study of Perceptual Diagnostic Judgments, Metacognition, and Reflective Practice”. She presented her research findings at various conferences, including the UCO education conference in 2015 and has run several short CPD courses on reflective practice. She is currently writing articles for publication: one on perceptual diagnostic judgments and metacognition, and the other one on reflective practice.

She is a practising osteopath who is registered with the General Osteopathic Council (GOsC).

During her previous employment at the Medical Research Council between 1985 and 1992, Cindy gained a research MPhil after studying the effects of iodine 125 decay on DNA strand breakage. She then trained as an osteopath and graduated in 2000. She was involved in teaching technique at UCO for 7 years and has been an osteopathic technique examiner and now is part of a team that assesses UCO dissertation presentations. 

Her practice and research interests include chronic pain, sports injuries, post and anti-natal conditions, and problems associated with babies and children.

Selected publications:

  • McIntyre, Cindy, Judith Lathlean, and Jorge E. Esteves. "Osteopathic clinical reasoning: An ethnographic study of perceptual diagnostic judgments, and metacognition." International Journal of Osteopathic Medicine (2018).
  • Currently writing for publication...McIntyre, Cindy, Lathlean Judith and Esteves Jorge E. “Osteopathic clinical reasoning: An ethnographic study of reflective practice.


Dr Jerry Draper-Rodi is a Senior Research Fellow at the UCO and an academic clinician.

His current roles include working as the Head of CPD and as a Research Lecturer at UCO, running an osteopathic practice in Oxfordshire, chairing Oxfordshire Osteopathic Network, and being on the executive committee of the Society for Back Pain Research. Jerry was awarded a Professional Doctorate in Osteopathy in 2016. His research was on the acceptability, feasibility and likely impact of a biopsychosocially-informed e-learning programme for non-specific LBP on experienced osteopathic practitioners' attitudes to back pain. He has presented his research at numerous conferences, including IFOMPT, SBPR, iO, CAMstrand and ICOM; and published articles in peer-reviewed journals and a book chapter. Jerry is a reviewer for the International Journal of Osteopathic Medicine. In 2016, Jerry received two prestigious awards, including The Research in Practice Award from the Institute of Osteopathy and The Secretaries Award from The Society for Back Pain Research. His research interests include biopsychosocial models of healthcare and their application within osteopathic practice, e-learning in osteopathic education, the effects of neuroscience education, clinical reasoning and mechanisms-based classification of pain, patients' experiences of biopsychosocial osteopathic care, and ways of assessing the therapeutic alliance.

Selected publications:

  • Timothée Cayrol, Emma Godfrey, Jerry Draper-Rodi, Lindsay Bearne. (2018). Exploring Professional Circus Artists’ Experience of Performance-Related Injury and Management. A Qualitative Study. Medical Problems of Performing Artists. (in press)
  • Draper-Rodi, Jerry, Steven Vogel, and Annette Bishop. (2018). "Identification of prognostic factors and assessment methods on the evaluation of non-specific low back pain in a biopsychosocial environment: A scoping review." International Journal of Osteopathic Medicine.
  • Thomson, Oliver P., et al. (2018) "'The ghost in the machine'-But whose ghost is it and what machine? A response to Wallden and Chek's editorials." Journal of Bodywork and Movement Therapies 22(4), 1022-1024.
  • Delion, T., & Draper-Rodi, J. (2018). University College of Osteopathy students' attitudes towards psychosocial risk factors and non-specific low back pain: A qualitative study. International Journal of Osteopathic Medicine, 29, 41-48.
  • Draper-Rodi, J., Vogel, S., & Bishop, A. (2016). Impact of an e-learning programme on the biopsychosocial model for non-specific low-back pain on experienced osteopaths’ attitudes to back pain: A mixed-methods study. Manual Therapy, 25(6), e167–e168.

Cancellation policy

The UCO regrets that no refunds can be made for cancelled places unless a substitute participant can be found. The UCO cannot guarantee that any course will run. In the event of your course being cancelled, all paid fees and deposits will be refunded in full.