Road traffic crashes result in approximately 36,000 hospitalised injuries annually in Australia.1 Non-catastrophic neck and back injuries, primarily whiplash-associated disorders, account for more than 75% of all survivable motor vehicle crash injuries, with up to 50% of individuals not recovering within 3 months and experiencing chronic pain.2 These cases present ongoing health and economic burdens.
We know that treating both the physical injury and the psychological effects together (a biopsychosocial approach) helps people recover better. Our earlier trial showed that when physiotherapists include psychological strategies to their usual treatment (the StressModex program), patients improved more. However, most physiotherapists in Australia don't use this combined approach. The main reason is that they haven't been trained in the psychological part and often do not feel confident delivering it.
Our earlier clinical trial showed that a 2-day in-person training course helped physiotherapists deliver the StressModex program well and improve patient outcomes. Unfortunately, running in-person training across the country is expensive and hard to scale. To overcome this barrier we worked with our partners to create a novel online training strategy called Physiotherapists bIopsyChosocial Online Training (PICOT). PICOT is designed to help physiotherapists learn and confidently use the StressModex approach in everyday practice.
Interested in this Clinical Trial? Whether you are a patient or healthcare professional, contact us: Contact
Funded by the Medical Research Future Fund, Professor Michele Sterling and team will compare the effectiveness of in-person training versus an online training program for physiotherapists delivering the StressModex intervention to people suffering from non-catastrophic road traffic injury. The main aims are to compare the:
- Effectiveness of the two implementation strategies (in-person training versus PICOT) for the delivery of StressModex in routine physiotherapy practice;
- Effectiveness of the two implementation strategies on patient outcomes; and
- Cost-effectiveness of the two implementation strategies.
The PICOT trial's set-up is well underway and we've completed the following milestones:
- Ethics approval
- Protocol
- Governance
- Consumer Advisory Group
- Redcap database
- Training curriculum
- Physiotherapist clinic recruitment
- Physiotherapist training of StressModex
Approximately 46 physiotherapy clinics across all Australian states and the Australian Capital Territory were trained in April 2025 and April 2026. Since completing their training, physiotherapists have been delivering psychologically informed care to clients at their respective clinics.
To do:
- Longitudinal data and clinical notes collection
- Data analysis
- Publications
Coordinating Principal Investigator
Professor Michele Sterling, The University of Queensland
Clinical Trial Coordinators
Dr Yanfei Xie, The University of Queensland
Dr Christopher Papic, The University of Queensland
Chief Investigators
Professor Michele Sterling, The University of Queensland
Dr Rachel Elphinston, The University of Queensland
Dr Roma Forbes, The University of Queensland
Professor Nadine Foster, The University of Queensland/STARS Research and Education Alliance
Associate Professor Jason Lodge, The University of Queensland
Dr Johanna Lynch, The University of Queensland
Associate Professor Shaun O'Leary, The University of Queensland
Dr Kerry Peek, The University of Sydney
Dr Jenny Setchell, The University of Queensland
Professor Helen Slater, Curtin University
Dr Julia Treleaven, The University of Queensland
Associate Professor Haitham Tuffaha, The University of Queensland
Associate Investigators
Tim Austin, The University of Sydney
David Brentnall, Axis Rehab
Professor Simon French, Macquarie University
Dr Kerrie Evans, The University of Sydney/Allsports Physiotherapy
Professor Michael Nicholas, Northern Sydney Local Health District
Professor Trudy Rebbeck, The University of Sydney
Professor Robert Ware, Griffith University
Research Assistants
Ms Chloe-Emily Eather, The University of Queensland
Mr Thomas Warner, The University of Queensland
Data Manager
Ms Maryrose Malt, The University of Queensland
Trial Administrator
Dr William McCann, The University of Queensland
Need to find a StressModex-trained physiotherapist?
There are 41 physiotherapist clinics in Australia with 111 physiotherapists trained in StressModex. View the list of clinics by State and Territory using the button below:
Experienced a Road Traffic Injury?
If you've recently had a road traffic injury with suspected whiplash or neck/back pain, contact a participating physiotherapy clinic for assessment and evidence-based StressModex treatment.
Funding Partners
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