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Pain Management

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Pain Management

Defining Pain

Role of psychologists in pain


management
CONTENT Approaches in pain management
S
Activity pacing

Mindfulness
An unpleasant sensory and emotional
experience associated with actual or
potential tissue damage or described in
terms of such damage.
DEFININ
G PAIN
Types of pain : Acute, Chronic,
Neuropathic and Nociceptive pain
evaluator/consultant

Role of therapist/ counselor (pain


psychologists psychologist)
in Pain reinforcer
management
outcomes analyst
EVALUATOR/CONSULTANT

The psychologist in the collect additional data complete the ‘big


role of consultant or regarding the patient’s picture’ psychosocial
evaluator can: pain complaints and medical history

use this information to


guide the suggest appropriate
establishment of outcome measurement
individual treatment of treatment gains
goals and algorithms
THERAPIST/ COUNSELOR
• Informational sessions can involve both the patient and family in order to:
1.prepare and educate about a specific procedure
2.clarify and reorient the patient to appropriate outcome expectations
3.set appropriate and manageable goals
4.increase motivation. Education itself can serve to reduce fear and anxiety about actual
surgical/medical procedures, the recovery process, risks, and alternatives
PAIN PSYCHOLOGIST
1.help the patient understand the dynamic interaction between pain and mood
2.help reduce emotional distress associated with the chronic pain experience
3.address long-standing psychopathology
4.help the patient develop adaptive strategies and skills to cope with stress and pain
REINFORCER
• ‘Relapse’ of pain complaints/behavior tends to occur when patients’ symptoms increase in
intensity, their perceived abilities of control are compromised, and their psychological
distress is magnified. ‘Relapse prevention’ interventions may produce improved outcomes
by helping patients to recognize and cope with these situations. 
1. Biofeedback and relaxation training (e.g., diaphragmatic breathing,
progressive muscle relaxation, autogenic training, self-hypnosis,
guided visual imagery) to reduce muscle tension and promote the
body’s calming response
2. General stress management techniques (e.g., time management,

APPROACHE problem-solving skills, assertive communication)


3. Anger management skills training
S TO PAIN 4. Increasing understanding of personality style and its contribution
to the pain experience
MANAGEME 5. Activity pacing and reducing fear of pain and/or activity avoidance

NT 6. Increasing acceptance of the chronic nature of pain condition


7. Reinforcement techniques to increase adaptive behaviors and
decrease maladaptive pain behaviors
8. Cognitive approaches to manage clinical depression and anxiety
disorders
•ACTIVITY PACING
• Pacing Instructions
Find a comfortable starting point (baseline):
ACTIVITY 1. Choose an activity - e.g. sitting, walking, mowing the grass

PACING
2. Measure the length of time you are comfortably able to do
this. Do this at least three separate times - on good days and
bad days
3. Take the average of these times, then subtract a fifth
• The first mindfulness session generally
incorporates the following:
• a) Discuss posture – alert versus not alert.
MINDFULNE • b) Ask participant to close eyes.
SS SESSION • c) Awareness exercise
• d) Breathing exercise
• e) Formal breathing
• Mindfulness feedback: a) Praise effort, not effect.
• b) Redirect the purpose from relaxation to awareness gently. Relaxation often occurs with
these exercises, which can be a bonus, but it is not the explicit purpose. Any decreases in
pain that occurred can be treated in the same fashion.
• c) Normalize the occurrence of distractions (e.g., “I kept being distracted by
pain/mood/feelings/sounds/etc.”). Reinforce noticing that a distraction has occurred
(e.g., self-awareness) and any efforts towards bringing awareness back to the present
moment.
THANK YOU

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