clinical education

A Functional Understanding of Human Rehabilitation (HRF-FU)

Course Description

This course provides a broad overview and practical application of contemporary pain science, movement science, manual therapy, communication, and behavior change utilizing a biopsychosocial process-based framework called the Human Framework Rehabilitation (HRF). The HRF is presented as transdiagnostic alternative to diagnosis classification and protocol for movement and rehabilitation specialists. This course work is a blend of lecture, lab, and case studies to maximize clinical application.

Course Background

The study of movement and pain has undergone significant changes in the last four decades as increased effort to move healthcare from a biomedical to biopsychosocial approach for care. The Human Rehabilitation Framework (HRF) is the world’s first biopsychosocial process-based approach to rehabilitation, accessible by all disciplines to deliver care in a transdisciplinary manner. It addresses the criticisms of the Biopsychosocial (BPS) Model and is an evolutionary step forward for Evidence-Based Practice (EBP), providing a new perspective that synthesizes scientific evidence, clinical practice, and personalized care. The HRF is based on the scientific philosophy of Functional Contextualism and replaces differential diagnosis, Clinical Practice Guidelines (CPGs), Clinical Prediction Rules (CPRs), and Clinical Pathways with a process-based approach for evaluation and intervention. It supports advances in personalized precision medicine and the value-based care model and is designed to be ready for the future of biomedicine and biopsychosocial research.

Course Target Audience: Physical Therapists, Athletic Trainers, Occupational Therapists, Chiropractors, Physical and Occupational Therapist Assistants, Massage Therapists, Counselors/Social Workers, Nurses/Nurse Practitioners, Osteopaths, Physicians, Rehabilitation Professional Students

Course Objectives

  1. To introduce the Human Rehabilitation Framework (HRF) as a biopsychosocial process-based treatment approach for rehabilitation.

  2. To provide an overview of current science-based knowledge related to pain science, movement, and manual therapy.
    Identify the nine biopsychosocial flexibility/inflexibility processes associated with the HRF.

  3. To discuss how the HRF integrates into the Extended Evolutionary Meta Model (EEMM) as it relates to the concepts facilitating behavior change which can be translated to patients as well as across different disciplines.

  4. Discuss the importance of viewing movement and posture within a functional contextualism perspective.

  5. Summarize the three categories of HRF biopsychosocial processes you can immediately implement in your clinical practice.

Current Offerings


Unlock the flexibility to learn at your own pace with our captivating online edition.


This course is only offered online for the time being. If you are interested in hosting a live course, please contact us!

Course Instructor

Dr. Leonard Van Gelder is a clinician, coach, researcher, & educator. He is a co-founder of, and serves in leadership roles for, the Institute of Contextual Health. He has been involved in the movement and rehabilitation field for over 20 years. During this time, he has studied, published research, and presented at regional and international conferences on the science of movement and pain. He has explored a diverse spectrum of manual therapy and movement approaches, and emphasizes a biopsychosocial approach to movement, manual therapy, and education in his practice. Leonard is the creator and lead developer of the Human Rehabilitation Framework (HRF).



Course Schedule

2-Day Live Schedule

Day 1 - 7.5 Hours

Introduction: 0.5 hours
• The Limitations of the Medical Diagnosis Model
• Rise and Fall of Evidence Based Medicine
• Protocols and Processes
• Philosophical Worldviews

Processes of Change: 1.5 hours
• Introduction to Processes of Change
• Functional Contextualism and Behavior Change
• Scope, precision, and depth as it relates to EBP
• Strongest mediators for behavior change
• Processes of Change in Rehab
• Process Based Approach and EEMM

Sociocultural Level 1: 1.5 hours
• Current Opioid Epidemic
• Mental health and Adverse Childhood Events (ACEs)
• Social Determinants of Health

Biophysiological Level: 1.5 hours
• Pain vs Nociception
• Brief note on perception
• Pain Definitions
• NEI relationships
• Respecting Inflammation and Healing Timelines
• Loading Capacity Processes

Movement / Postural Dimensions: 1.5 hour
• Rethinking Posture
• Rethinking Movement
• Biomechanical Considerations
• Motor Variability/Invariability
• Letting Go of Stability
• Movement Boundaries
• Manual Therapy

Breakout groups and practice of movement experiments: 1 hour

Day 2 - 7.5 Hours

Relational Frame Theory (RFT): 1.5 hours
• RFT introduction
• Therapeutic Neuroscience Education (TNE) in the context of RFT
• Educational Considerations
• Review of BPS Model

Cognitive Dimension 0.5 hours
• Discussion of Cognitive Fusion/Defusion
• RFT review

Attention Dimension: 0.5 hours
• Sensory Awareness
• Discussion of Presence/Conceptualized of Past/Future

Emotional Dimension: 0.5 hours
• Reminder of physical implications
• Discussion of Expansion / Acceptance Processes
• RFT review and integration

Self Dimension: 1 hour
• Self as a Perspective
• Self as a Process
• Self as a Story
• Observing self vs conceptualized self-processes

Motivation Dimension: 0.5 hours
• Lack of Values/Clarifying Values
• Values Compass Work

General Behavior Change Dimensions: 1 hour
• Behavior Change Across Disciplines
• Fear Avoidance vs Persistent Behavior
• Sleep
• Pacing
• Physical Activity
• Graded Exposure
• The symptom modification discussion

Putting it All Together: 1.5 hours
• HRF Flexibility
• Where Humans Get Stuck
• How to help them get unstuck

Cases: 1 hour
• Sam & John
• Functional Network Analysis
• Sneak peek to advanced courses – EEMM
• Cases as a group

Closing Remarks

This course has been approved by The American Physical Therapy Association, Michigan Chapter for Physical Therapists and Physical Therapy Assistants for 15 CEUs and is eligible for PDR credit in the area of pain and symptom management for Michigan Physical Therapy Licensure.

Cancellation Policy

Cancellations received at least 7 business days before the event are 100% refundable. There will be no refund for cancellations received later. If participants register and do not attend, they are still responsible for full payment. Participants will need to contact IOCH via phone or email with a request for refund. IOCH will process the participant’s refund within 3-5 business days from the day the request is received.

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