Hybrid: Norwegian Psychomotor Physiotherapy (NPMP) -

Basic education for physiotherapists

This basic education contributes to the professionalization of physiotherapists in accordance with the competency profile for mental health physiotherapy in Austria. 

Psychosocial burdens and mental health problems are increasing in our society. Persistent stress and strain, demanding and traumatising life experiences, as well as disease and injuries affect our bodies and the way we move, express, and experience ourselves. Overload causes sufferings that are often experienced in bodily ways, and frequently lead people to physiotherapy. Consequently, physiotherapists are confronted with the increased muscle tension, the unspecific pain, and the somatically unexplained symptoms many patients suffer from. Such conditions are challenging to understand and treat, both in general and specialized clinical practices.

Norwegian Psychomotor Physiotherapy (NPMP) is developed from clinical practice in both orthopaedics and psychiatry. It is a well-established physiotherapy approach in Norway, supported by evidence and experience-based knowledge which has grown over many years. The underlying assumptions of this approach underpin that the muscular functions of posture, movement and breathing express how a person has coped with challenges and emotional overload in life. Life history and current circumstances will influence resources and limitations in the bodily organism as a whole. 

Treatment is based on functional assessment of the dynamic between stability and mobility, how this effects breathing, and the possibilities for adjustment and change. The approach is continuously adapted to how the patient responds and reacts, and how life circumstances allow for changes in bodily tension patterns. Local symptoms are always understood in light of the tension pattern as a whole.

NPMP is a treatment approach suitable in all clinical fields where physiotherapists address muscular tension, breathing problems, long-lasting and/or complex unexplained musculoskeletal pain, anxiety, psychosomatic disorders, and fatigue in their patients.

This basic education gives a profound introduction and clinical competence for physiotherapists to work with NPMP. It comprises four meetings in Vienna including practical and theoretical lessons, supervision, and individual treatment sessions. The individual treatment is crucial to get a deeper and bodily understanding of NPMP. During the whole period of the education, guided self-studies in small colloquium groups promote a continuous practical and theoretical learning process. For detailed information on the content, please see below.

To receive a certificate after the education, the participants demonstrate an individual treatment session and discuss their approach and reasoning with the course leaders. This practical exam is followed by a theoretical exam, which is a written paper in English or German. It comprises the description of a case from clinical practice in combination with a theoretical perspective on NPMP. 

Detailed content

Preparation for Course I

Physiotherapists who are admitted to the education will receive introductory literature ahead of course I. This literature shall be read and reflected upon. Learning points and questions shall be written down and brought to course I.

Course I 

Introduction and examination - NPMP trial treatment

This course comprises an introduction to NPMP from a historical, theoretical, and practical perspective. The structured and comprehensive assessment of NPMP, also called a trial treatment, is taught. The participants learn to examine the patient´s tension pattern including body posture, breathing, active and passive movement patterns, the muscular qualities, and autonomous and/or emotional reactions, as well as how the patient senses and experiences their own body during the assessment. The NPMP assessment always entails reflections on the physical findings in the context of the patients’ emotional challenges and life experiences and their current life situation. 

The conclusion of this assessment should indicate how the patient’s health problems may be related to the tension pattern and whether physiotherapy is indicated. If so, what possible changes should the approach emphasise to help the patient to improve adjustability, better dynamic between stability and mobility, and freedom to breath. The participants increase their knowledge and skills to give individually adapted treatment, according to the conclusion.

Methods:

• Theoretical lessons
• Demonstrations, observations
• Practical sessions
• Group work
• Discussions
  

Course II

Treatment approach - principles and individual adaptation

Based on the NPMP assessment taught in course I the participants learn to expand on their knowledge to widen the approach of the individually adapted treatment. The work with cases from clinical practice of the participants is an important part for the learning process. The participants learn to focus on the continuous evaluation of the patient`s situation and reactions, to work process-oriented in physiotherapy. 

Central to this is the careful adaptation of the treatment approach in accordance with the present resources and situation of the patient. This includes knowledge about the patients' emotional situation and life history (e.g., trauma and anxiety). In this light, more stabilizing or liberating elements of NPMP are addressed.   

Methods:

• Theoretical lessons
• Demonstrations, observations
• Practical sessions
• Group work
• Discussions

Course III

Practical deepening 

The main focus of this course is the practical work with NPMP, where the participants work in various roles: physiotherapist, patient, observer, and in reflecting teams. These different perspectives promote a deeper understanding of NPMP by the means of experience, demonstration, reflection, and discussion. At the same time, the practical work functions as a preparation for the following practical exam.

Self-studies in learning groups (colloquium)

To learn NPMP, a continuous process integrating practice, discussion, and theory, is necessary. Therefore, the participants will deepen their knowledge and skills in small colloquial learning groups between the meetings. They comprise practical work on each other (in the roles of therapist, patient, and observer), the reflection on and conclusions from clinical practice, and the discussion of literature. In total, the colloquium comprises 50 hours of meeting in the group, which can be partly organized online. During course I, the groups will be established and more information on the scope and timeline will be given.

Group supervision (online and in Vienna)

The participants bring cases from clinical practice which are the basis for supervision. Both written cases and video sequences will be forms to present and discuss clinical work. If video sequences cannot be taken with patients for ethical reasons, they may be made with a colleague/friend who consents that this video is shown during the education. The cases build the basis to deepen practical skills in close relation to clinical practice, to address challenges, and to integrate suitable theory from the literature study.

Individual treatment

To experience the treatment on one´s own body is a very important aspect of learning NPMP. Usually, these practical impressions are the most direct experiences of the treatment that help to increase a bodily understanding of NPMP, which is again an important basis for the treatment you give later to the patients. Therefore, six individual treatment sessions are scheduled during the course of the basic education.

Practical exam 

During the practical exam the participants demonstrate an individual NPMP treatment session with a colleague and discuss their approach and reasoning with the course leaders. More information will be given during course I. The exam will be prepared during course III and completed at the end of the course. 

Grading scale: Pass/Fail.

Written exam

The written exam consists of a paper (around 6-10 pages, written in English or German) and includes the summary of a case from clinical practice, a reflection about the learning process of NPMP, and a theoretical perspective in relation to clinical practice. More information will be given during course I. 

Grading scale: Pass/Fail. 

Certificate

After having passed the practical and written exams, the participants will receive a certificate confirming the completion of the basic education in NPMP. The content of this education will be described in the certificate.  

Instructors: Randi Sviland, PhD and Tove Dragesund, PhD 

Assistance: Stefan Perner, MSc