Units of the PSP Certification Program™

Unit 1 – Principles of Primary Spine Care

Unit 2 – The Lumbar Spine

Unit 3 – The Cervical Spine

Unit 4 – Clinical Management and Final Proficiency Exam

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Unit 4 – Clinical Management and Final Proficiency Exam

Unit 4 – Online Educational Modules:

Topic 1: Psycho-Social Factors and Chronic Pain

  • Review of Pain Neuroscience
  • Educating Patients Regarding Pain Neuroscience
  • Principles of Graded Exposure in Chronic Pain Patients
  • Review of Fibromyalgia and Chronic Widespread Pain (Parts 1 & 2)
  • Motivational Interviewing
    • Background & Spirit
    • Skills & Strategies
    • Processes
    • Screening, Brief Intervention, & Referral to Treatment (SBIRT)
  • Perceived injustice
  • The CBT/ACT Context in PSP Practice
  • Review of Key Psychological Factors (Parts 1 & 2)
  • Principles of Cognitive Behavioral Therapy (CBT)
  • Principles of Acceptance and Commitment Therapy (ACT)
  • General Communication Skills
  • Mindfulness
  • Psychoactive Medications (Parts 1 and 2)

Topic 2: Clinical management

  • Moving beyond diagnosis and treatment to clinical decision making and clinical management: the true PSP
  • Team Based Care


Topic 3: Pharmacology

  • Part 1: Medications that are prescribed for spine pain
    • Anti-inflammatory medications: NSAIDs, steroids
    • Pain medications: acetaminophen, opioids
    • Muscle relaxants
    • Anti-convulsants
    • mood stabilizers
  • Part 2: Medications that can produce musculoskeletal side effects
  • Part 3: Identifying aberrant drug behavior


Topic 4: Principles of Evidence-Based Practice

  • Overview of EBP – what is it?
  • Overview of research designs
  • Basic science research
  • Observational studies
  • Diagnostic studies
  • Qualitative research
  • Randomized, controlled trials, meta-analyses and systematic reviews
  • Asking clinical questions and seeking the answer


Topic 5: Work-Related Topics

  • Stay at Work/ Return to Work process
  • Functional capacity evaluations
  • Work Conditioning/Work Hardening
  • Chronic Pain Management Programs/Functional Restoration


Topic 6: Cervical Manipulation and Stroke – an Understanding for the PSP

  • Review
    • Pathophysiology of vertebral artery dissection
    • Epidemiology of vertebral artery dissection
    • Most common initial symptoms
  • The evolution of the association between CMT and vertebral artery dissection
    • Case reports and case series
    • Surveys
    • Biomechanical studies
    • Case-control studies
  • Where are we now?
    • How to communicate vertebral artery dissection as a “risk”
    • How to detect subtle signs and symptoms (if they are present)
    • What to do if a patient has a stroke in your office


Topic 7: Special topics

  • Primary spine care in the context of public health Part 1
  • Primary spine care in the context of public health Part 2
  • Pre/Post Surgical Procedures
  • Scoliosis


Topic 8: Written documentation and communication

  • Documentation: Part 1
  • Documentation: Part 2

Unit 4 – Live 2-Day Workshop:

The following topics will be covered:


  • Introduction: what are you hoping to get out of this course? What are your greatest challenges with patients?
  • Communication skills
  • Practical application of the principles of:
    • Cognitive Behavioral Therapy
    • Acceptance and Commitment Therapy
    • Motivational Interviewing
  • Pain coping skills
  • Brief mindfulness exercises for the PSP
  • Role playing exercises
  • Clinical Vignettes
  • Videos of “good” and “bad” patient/ PSP interactions

Review of the principles of primary spine care and CRISP® Protocols


Clinical decision making

  • regarding treatment recommendations and what to do each visit
  • regarding end point of care
  • what if the patient does not respond to an adequate trial of treatment?
  • regarding invasive or intensive interventions


Relationship-Centered Care and the Therapeutic Alliance revisited

  • Affective reassurance
  • Cognitive Reassurance
  • Use of language


Thoracic Pain


Multiple Actual Cases of various clinical scenarios in Primary Spine Care - Interactive discussions

Final – Live Practical Competency Examination

The live practical exam will be provided as a part of the live workshops.

Details on the content of the exam will be discussed in each of your workshops leading up to the final. 

(please note that the content will be updated as needed)


Updated | 04.23.2019

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Questions regarding the program:

Michael Timko, PT, MS, FAAOMPT
  PSP - Program Manager

University of Pittsburgh
School of Health and Rehabilitation Sciences
Department of Physical Therapy
  Bridgeside Point 1
  100 Technology Drive, Suite 210
  Pittsburgh, PA 15219
  (412) 383-6578


Questions regarding program registration:

Debra Utterback
  PSP - Registration Manager

University of Pittsburgh
School of Health and Rehabilitation Sciences
Department of Phsycial Therapy
  Bridgeside Point 1
  100 Technology Drive, Suite 210
  Pittsburgh, PA 15219
  (412) 383-6942


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