University of Oulu

Riikka Holopainen, Mikko Lausmaa, Sara Edlund, Johan Carstens-Söderstrand, Jaro Karppinen, Peter O’Sullivan & Steven J. Linton (2021) Physiotherapists’ validating and invalidating communication before and after participating in brief cognitive functional therapy training. Test of concept study, European Journal of Physiotherapy, DOI: 10.1080/21679169.2021.1967446

Physiotherapists’ validating and invalidating communication before and after participating in brief cognitive functional therapy training : test of concept study

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Author: Holopainen, Riikka1; Lausmaa, Mikko2; Edlund, Sara3;
Organizations: 1Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Department of Law, Psychology, and Social Work, Center for Health and Medical Psychology, Örebro University, Örebro, Sweden
4Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
5School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
6Body Logic Physiotherapy, Perth, Australia
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.7 MB)
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Language: English
Published: Informa, 2021
Publish Date: 2023-03-24


Objective: The aim of this study was to investigate physiotherapists’ validating and invalidating communication, before and after brief Cognitive Functional Therapy (CFT) training that included a session on validation skills. Associations between validation/invalidation and the characteristics of the interviews and physiotherapists were also explored.

Methods: Eighteen physiotherapists treating patients with low back pain participated in the study. The study had a within-group design in which validation and invalidation for physiotherapists were rated before and after training using a reliable observational scale. We also collected data on interview length and physiotherapists’ and patients’ speech percentages.

Results: The physiotherapists’ validating responses increased and invalidating responses decreased from pre- to post-training. The within-group effect size was large for validating responses and medium for invalidating responses. The interview length increased from pre- to post-training (large effect size). However, the reason for this was related to factors other than validation and invalidation. The results indicate that increased validation is associated with an increase in physiotherapists’ speech percentage.

Conclusions: The results of this study show changes in validating and invalidating communication among physiotherapists from pre- to post-CFT training. The study also found associations between specific interview characteristics and validating communication. Future studies with larger samples and control groups are needed.

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Series: European journal of physiotherapy
ISSN: 2167-9169
ISSN-E: 2167-9177
ISSN-L: 2167-9169
Volume: In press
DOI: 10.1080/21679169.2021.1967446
Type of Publication: A1 Journal article – refereed
Field of Science: 217 Medical engineering
3141 Health care science
316 Nursing
Copyright information: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (,which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.