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Counseling Tools (Life Hacks) for Chronic Pain Management
Dr. Dawn-Elise Snipes PhD, LPC, LMHC
Executive Director, AllCEUs
Objectives
Define the problem
Examine the similarities between CNCP, mental health issues and addiction
Identify the impact of CNCP on patients
Explore biopsychosocial resource needs for secondary and tertiary prevention.
Effective pain management in patients with comorbid issues must address all conditions simultaneously.
Biopsychosocial Impact of Pain…
Assessing for Chronic Pain
Assessment of CNCP should document:
Pain onset, quality, and severity
Results of investigations into etiology
Pain-related functional impairment
Emotional changes (e.g., anxiety, depression, anger)
Pre-existing mental health, trauma or addiction issues
Cognitive changes (e.g., attentional capacity, memory)
Assessment cont…
Beliefs about the pain that they experience such as what causes it, how long it will last, whether it is curable, what effects it will have in their lives, what treatments might be relevant, and whether it is understood and believed as “real” by clinicians
Family response to pain (i.e., supportive, enabling, rejecting)
Parental cognitive responses to pain, such as parental pain catastrophizing or exaggerated negative pain appraisals, have been found to influence both parents’ emotional reactions to pain and child functional disability
Assessment cont…
Environmental consequences (e.g., disability income, loss of desired activities, absence from desirable or feared work)
Daily pain assessment
Descriptive language
Numerical Scales
Verbal Scales
Visual Scales
Exacerbating and mitigating factors
Goals of Chronic Care Models
Shift from acute & episodic to ongoing proactive care
Emphasizes
Prevention (getting worse, developing other conditions)
Patient’s role in managing health with mutual goal setting and action planning (self-management)
The goal of self-management interventions are to:
Improve knowledge about the condition and intervention options
Increase confidence in the ability to change
Leverage what he or she can do to promote personal health (prevention)
Improve motivation and problem solving rather than simple compliance with a caregiver’s advice
Help the participants’ master six fundamental self-management tasks:
Solving problems including preventing problems and relapse
Making decisions
Using resources
Forming a patient -provider partnership
Making action plans for health behavior change
Self-tailoring
Developing Acceptance
Deciding that pain “is” and choosing not to focus/dwell on it leads to:
Lower pain intensity.
Less pain-related anxiety and avoidance.
Less depression.
Less physical and psychosocial disability.
More daily uptime.
Better work status.
For a list of tools to assess coping, see TIP 54, Chapter 2, Exhibit 2-12.
Summary
There are many similarities between Pain, mood and addictive disorders
Integrated, concurrent, biopsychosocial treatment is vital
Mood impacts pain which impacts life satisfaction
Recovery supports realistic beliefs and identifies controllable factors enhanced outcomes
Patients with current addictions or mental health issues need concurrent treatment
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