A model, not a methodology

The Integrated Systems Model has evolved from 40 years of collaborative clinical and education experience.  It is a framework to help clinicians organize their knowledge and provide the best possible treatment for the individual patient.  Since every clinician has a different skill set, an ISM therapist will never be a clone of someone else nor will they only adhere to specific therapies or algorithms. Each therapist is as unique and individual as the people they seek to help, why would therapy be any different?  The Integrated Systems Model umbrellas all others.


Jen Cardew explains what the Integrated Systems Model has brought to her physiotherapy practice.  The ISM Series course will do the same for yours (The ISM Series).

Diane was part of team of Canadian physiotherapist educators who in the late 1970’s and early 1980’s decided that Canada would aim to integrate knowledge from multiple sources in all courses.  The video below describes how this Canadian integrated approach formed the foundation for the development of the North American Institute of Manual Therapy.


Another example of how we aspire to learn with one another.

What does it mean and where did it come from?

In 2010, Diane Lee and Linda-Joy Lee decided on the words the ‘Integrated Systems Model’ to identify the collaborative approach they were teaching, lecturing and writing about. Diane invited Linda-Joy to contribute to the 4th edition of The Pelvic Girdle (first edition 1989) since their collaborative work was going to be featured throughout this version. After much deliberation and clinical reflection they settled on the word ‘integration’ as being representative of what they were trying to help clinicians understand.  How do the various systems we primarily treat in the scope of physiotherapy contribute to both optimal and non-optimal strategies for function and performance? We hoped that consistent language and communication would expedite and facilitate better treatment for better outcomes for our individual patients.

After naming our approach the Integrated Systems Model for Disability and Pain, we were introduced to Dan Siegel’s work through his book Mindsight.  Siegel defines integration as ‘the linkage of differentiated elements to illuminate a pathway to health’.  How perfect was that!  It still is.

In order to treat a whole person with a biopsychosocial model one needs to understand the relationship and contribution of various systems (differentiated elements) that are ultimately manifesting as cognitive, emotional or sensorial dissonance.  In complex situations, a clinician often wonders ‘where do I start’?  Treating the underlying problem and not merely the symptom is fundamental to CAMT teaching, long established in the Canadian orthopaedic curriculum. ‘Finding the Driver’ (ISM language) is merely another way of saying the same thing – find the best place to start treatment.

Discover Physio

In 2010, Diane and Linda-Joy officially partnered and established Discover Physio, an education company representing their collaborative work. In March 2013, Diane decided to leave this partnership and in June 2013 Discover Physio was legally dissolved.  Each now offers independent courses that reflect their collaboration and highlight their individuality, skill sets and teaching styles.

The future of ISM

Diane has continued to use an abbreviated title – the ‘Integrated Systems Model’ – or ISM to identify the approach she teaches and will always credit the origin of the model to both herself and Linda-Joy Lee.  However, models evolve over time and many new concepts, ideas, techniques and learning tools have been added since the Discover Physio partnership dissolved.  The Integrated Systems Model has a wonderful definition and its intention was (and is) to help clinicians organize their knowledge for best practice.  It is a clinical reasoning approach that has FACES – it is flexible, adaptive, cohesive, energized and stable, a quality of integration according to Dan Siegel.  The ISM courses offer education, clinical mentorship and certification and draw from the evidence as well as Diane’s extensive clinical experience and worldwide collaborative network of professionals.

Come learn with Diane Lee, not from, but with – together we will continue to grow, evolve and integrate new knowledge into clinical practice. All past Discover Physio Series graduates are invited to join the journey.

© Diane G. Lee Physiotherapist corporation All rights reserved.