Taking a short break

Just for a fortnight…
Back soon!

7 Google Apps Every Health Professional Should Know About

Today is my first guest post for this blog! I hope you enjoy it – and thanks to Lis from Perth for getting in touch with me!

More and more web hosting providers, particularly the ones that are free, are powerfully persuading their clients to use Google Apps in order to manage their email more efficiently. This is typically due to the fact that the hosting provider wants to lower the overhead cost for processing that comes with operating POP accounts and saving disk space related to mail storage. In general, by using Google Apps, you get better performance and often better email support from your host. For example, if your host includes a single catch all type of email, you would probably still benefit from the use of Google Apps. You do have other options when it comes to email solutions, but all too often you will pay more and still not have the same full functionality that you get with Google Apps. Once you log on to Google Apps, you will soon see that it is much more than email. With your basic Google Apps account, you can enjoy benefits such as:

  • Add more domains
  • Add up to a hundred users
  • Each user account includes a separate email
  • A chat facility for users
  • Work together and share documents
  • Design public or private sites online or work as a team with others to build websites
  • A group calendar
  • Build a home page and select the Google widgets that your users can see
  • Fully functional email

This may all sound like a bit much for a medical professional that only needs a couple of email accounts and your own domain. No problem, Google Apps allows you to turn off any feature that you do not need. Essential Google Apps For Medical Pro’s With Google Apps, medical professionals will enjoy email accounts, sharing files, creating schedules and chatting in real time. Not only are these tools great for business, but can also be used effectively on a personal level as well.

Here are the top Google Apps that every health professional should explore:

1. Gmail - Enjoy the benefits of reduced spam mail; stay connected by accessing Gmail on your mobile device and lots of storage space.

2. Google Docs - A great way to create your work online and share it with others. Upload right from your desktop; edit anytime or place; choose you is allowed access; share changes to your documents in real time; and store files online securely.

3. Google Calendar – Never forget another appointment with SMS and email reminders. You can also schedule events from anywhere with mobile access.

4. Google Talk – Allows you to chat with patients and colleagues in real time. You can chat right from Gmail and easily cross over from text to voice chat.

5. Google Sites – Makes it easy to create and share group websites. Create a webpage with a single click. You do not have to be fluent in HTML to create a customized look and feel.

6. Google Videos – Upload your videos for free, email videos to patients and colleagues or post to your website or blog.

7. Google Mobile – Allows you to add Google products to your mobile devices.

It has never been easier to get Gmail, Search, YouTube, Maps and much, much more on the go. Create your own combination of these tools to enhance your medical business, or use them all together and manage you files, patients, records, etc. from anywhere on the planet.

Dena White is a freelance author and writes about healthcare career topics, such as how to obtain an online nursing degree, tips for job advancement, and more.

Health coaching resources and worksheets

I thought I’d do a quick search through the internet to locate resources and worksheets for health coaching – and what a wealth there is! I’m not sure about the grammar of that last sentence, but I am sure of the amazing amount of material there is online.

First up, a link back to Health Coaching Australia, with a very good series of worksheets in pdf format on topics like a healthy goal action plan, a weekly goal checklist, a ‘change your mind’ worksheet (decisional balance), and an ‘activity pyramid’ for the elderly.  All work looking at and perhaps modifying if you need to.

University of Iowa provides a health coaching service – and has several worksheets that could be used as an initial screening or record tool, and one that I liked especially, a ‘roles and responsibilities’ sheet listing the expectations from each person in the coaching relationship.  If you head to the ‘Resources’ section you can find further tools mainly for more general health situations such as a food diary, and a headache diary with some helpful ideas for what to record.

If you’re curious about the various self management programmes available, this summary outlines some of the more popular generic programmes that have been used around the world.  It does give some dollar figures, but I can’t be certain whether these are up-to-date, so it would pay to make contact with the providers before saving your pennies!

A very helpful bibliography for anyone thinking about chronic conditions self management is available here, while this page lists a huge number of tools for developing chronic care management within a clinical practice setting.  I really liked the ‘Patient Assessment’ tool, but it’s certainly not the only one you could use.  Also available at The Robert Wood Johnson Foundation website, is a very practical booklet called ‘Partnering in Self Management Support: A toolkit for clinicians’. This includes some really great steps you can include to ensure your patients really do understand what their health problem is, and what they can do to help themselves.

Before, During, and After the Visit

  • Help patients understand their central role in managing their conditions and that the entire health care team is there to help.

Before the Visit

  • Make time for self-management by gathering clinical and patient experience data in the chart.
  • Ask patients to bring questions and concerns and health monitoring information.

During the Visit

  • Collaboratively develop a visit agenda with the patient and family, handling as many concerns as possible, and plan return visits as appropriate.
  • Engage the entire practice team in supporting patients, use “warm handoff” introductions, and explain team member roles to patients.
  • Ask about patient goals to improve their health and help them make action plans that build confidence in their ability to reach these goals.
  • Use “ask-tell-ask” to provide just the right information at just the right time and “close the loop” to ensure patients know how to use the information.
  • Prepare a written care plan or visit summary that includes goals and action plans to ensure patients and families know what to do when they leave the visit.
  • Use group medical appointments, peer-led support groups, or patient education classes to provide opportunities for patients to share experiences and support.

After the Visit

  • Organize follow-up support to help patients sustain healthy behaviors between visits.
  • Extend care into the community by linking patients to community programs.

Build a Team

  • Designate and train a lead coach for self-management support who will support ongoing staff development of skills.
  • Assign responsibility for self-management tasks to all team members, extending the work out from the physician.
  • Use daily team huddles to review the schedule of patient charts, anticipate care needs, and enhance the flow of care.

While pondering the idea of self management, and all the wonderful resources available to do this, I had to pause and consider the differences between chronic disease management like diabetes and obesity or chronic respiratory disease.  I see one of the main differences is that many people with chronic pain are still searching for ‘the cure’ or for pain reduction through medical or pharmacological management.

Unlike people with diabetes, for example, who are clearly aware that their disorder cannot be ‘fixed’, people with chronic pain often continue to hope (and at times be promised) that their pain will be completely abolished. The mixed messages that people with chronic pain often receive, both from those unscrupulous purveyors of lotions, potions and magnetic devices – as well as well-meaning but also misguided individuals who believe they have ‘the answer’ and that pain reduction should be the only focus – can lead people with chronic pain to fruitlessly pursue pain reduction instead of learning to live good and healthy lives despite their pain.
Self management doesn’t seem to work well when the promise of removing pain remains the focus.

This makes the work of helping people look to developing self management of their chronic pain so much more challenging that working with people with other health conditions. So many of the messages that we need to convey to people with chronic pain run counter to popular belief – like being active despite pain, taking medication on a regular basis even when pain isn’t high, doing no more on good days than on bad, no less on bad days than good, that X-rays aren’t helpful in most low back pain – the list goes on.

I applaud the idea of self management and health coaching.  I hope that it becomes a standard approach to managing chronic conditions – and maybe the idea that much of health comes from what you and I actually do for ourselves might rub off in the management of chronic pain.

Health coach?

I wonder what it would be like to change our focus in pain management – what if we looked to promote wellbeing rather than ‘manage pain’? What would this look like?
Today’s post I want to dream a little – call it me an idealist, but I think if we start with a vision of what might be, and work towards it, we’ll go much further than if we look only to what can be. I’ve been thinking about the concept of health coaching for a while now – I think if I can do with one, I’m surely not the only person!

What I mean by a health coach is someone who spends time finding out what you want to create in your life, then helps you put the things in place to achieve it. I think it’s a bit different from ‘being a therapist’, or ‘treating’ someone, because the focus is on creating the positive rather than overcoming the negative.

I’m not the only person to have thought of this idea! In Australia there is ‘Health Coaching Australia’, and in New Zealand there are several practices where health coaches work – unfortunately, these ones are tied in with naturopathy and personal training rather than an evidence-based approach to living well.

So, what could something like this look like?
Well, coaching is about helping people define a goal and systematically work towards it. A coach can help resolve ambivalence, encourage, crack the whip and generally kick butt when needed. A coach doesn’t define the goal, the person usually knows what he or she wants to achieve, but acknowledges that getting there can be difficult on your own – a coach supplies that definition and urgency to persevere and stay honest!

I’d love to see people with chronic pain view their situation as an opportunity to learn to live well. To infuse their days with the good things that they can have despite chronic pain, and to see the limitations that chronic pain brings as a way to recognise the need to build resilience and flexibility. This doesn’t mean that having chronic pain is a walk in the park – it’s a truly frustrating experience. But the things we do to learn to live with chronic pain are not a lot different from the things we do to live well without chronic pain. We want time with family and friends, good sleep, paced energy through the day, a good diet, an exercise programme that fits our lifestyle, time alone, time to create, fulfilling jobs – sound strange? or sound like what a good life consists of?

It may simply be a change of perspective rather than a whole new approach, but I think I’d rather be cheering on the sidelines than being ‘a therapist’ in an office. I’d rather see people out in the world doing what they love than working out their ‘problems’ and ‘addressing issues’. Problems and issues certainly arise, but I wonder whether they would have that heaviness and emotional drag if we viewed them as obstacles to climb over or zigzag through on our pursuit of the good and healthy, rather than ‘issues’ that need to be dug through.

For some good reading on this idea of health coaching, there are lots of resources here at Health Coaching Australia. This is a paper from 2003 used as a briefing document for health practices in the UK. This document is a great dispeller of myths about men’s health.., and this is a nice summary assessment form if you were going to look at health in general with someone.

What’s different about the health coaching approach? I think it’s the view that the person being coached can decide whether or not to follow the coaching – a coach cares and encourages, but doesn’t actually run the race or play the game, that’s up to the person. What a nice way to view health management!

Friday funnies!

And sadly, this one too…
chicken

I will not even start on the Michael Jackson or Farrah Fawcett jokes… but leave you with this one, and would you believe, Manly Jack sent it to me so I could check whether I had swine flu? Don’t go to work if this is what YOU see in the mirror tomorrow morning…
image001

Splish! Splash! Hydrotherapy for chronic back pain is pretty good!

ResearchBlogging.org
Just a quickie post this morning, but one that I couldn’t resist.
You know how nice it is to be soaking in a hot bath or hot pools after doing some great energetic thing (vacuuming the house? gardening?) – and how many people with chronic pain tell us that a soak in a bath or a hot shower is just great? Well, this study uses a randomised trial looking at traditional exercise or exercise in 33 degree water – and guess what? The exercise in water worked best.

Not too fast there OK, the research design for this study does NOT compare apples with apples. Let’s take a look at some of the problems that I see with the methodology (and why you need to read the research not just cut to the conclusions).

There are a couple of things that help with ‘motivation’ or adherence to treatment – the first is contact with a person who will encourage you, the second is ongoing monitoring, and the third is to have something ’special’ happening or a ’special’ place to go to do the treatment. And this study, unfortunately, suffers for not controlling for these variables between the two groups.

The hydrotherapy group got to come in for therapy five times a week, for four weeks, under the supervision of a physiotherapist. And the other group? Given a sheet of exercises, told what to do by the physiotherapist, then left to it. Four weeks later, the results were assessed.

Given our chronic pain population who are often reluctant to move, need a lot of encouragement and supervision, and are probably going to experience an increase in pain especially after the first few exercise sessions, which group do you think did better? Which group do you think actually did the exercise?! I’m prepared to lay money on the group that had supervision, lovely warm water, and had to come in on a regular basis…

A couple of other thoughts occur to me also – when do you think the best time for measuring an outcome might be? Immediately at the conclusion of a treatment or sometime later when the expectancy effects have settled, and the reality of ‘life’ intervenes and the residual effects are what remains? This study measured outcome immediately at the conclusion of the treatment period, so didn’t control for these very influential factors.

I’ll bet that over the next couple of months, there will be a rise in the prescription of hydrotherapy under supervision by a physiotherapist, with this study being cited as a good reason for doing so. I mean, this is a study published in a well-established peer-reviewed and very influential journal. But hold on folks – how good is this study really? Would you want to draw conclusions from this?

Dundar U, Solak O, Yigit I, Evcik D, Kavuncu V. (2009). Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. Spine, 34 (14), 1436-1440

A Positive Case Formulation for Chronic Pain

The past couple of days I’ve looked at resilience, strengths and growth as part of assessing a person with chronic pain. The rationale is that although we are often seeking to provide support for deficits, or develop strengths, I wonder whether we always appreciate what people already have used to live with their pain.

To illustrate how we might include positive coping resources, I thought I’d provide a case study, based on a real person but with details somewhat disguised to protect confidentiality.


Kevin is an ex-mechanic with low back pain that hasn’t responded well to nerve blocks.
He’s had his pain for about three years now, moved away from fixing motors and is now trying to return to work in a completely different occupation – parts sales. The problems he identifies are difficulty bending, reaching and sustaining any sitting or standing position for more than 20 minutes.

He readily acknowledges that he avoids doing things that ‘might’ hurt – but at the same time appreciates that his pain can come ‘out of the blue’, sometimes affecting him when he’s doing something he often does, like doing up his shoelaces, and sometimes not. This has made him somewhat cautious about all movements, and to look at him, it’s easy to see that he holds himself in a ramrod-straight and upright position at all times.

He has difficulty selectively recruiting and relaxing muscles as he moves, and at the same time as moving, he hardly breathes. He’s recently acknowledged that he’s feeling out of control of his moods, and that his family life is pretty strained.

Doesn’t sound terribly positive, does it?!
A typical formulation might suggest that he has a pain-related anxiety with avoidance, heightened physiological arousal, and very strong beliefs about how things ’should’ be, along with poor motor control leading to erratic recruitment of muscles which also lead to altered sensory input to and from the neuromatrix.

Treatment might include giving him a cognitive model for his pain – such as introducing him to the pain-related anxiety and avoidance model, following an exposure-based programme for reducing his fear of specific movements, guiding movement patterns so he can obtain more accurate feedback from his body to his brain, helping him develop more flexible cognitions around what is and is not OK, and helping him reduce his physiological arousal through relaxation or other self regulation strategies.

All of these approaches might help him, and address some of the underlying deficits in his coping, but it does look like an incredibly enormous amount of work and quite a daunting list of ‘problems’ to ’solve’! I wonder what would happen if we looked at some of his strengths?

He has demonstrated the ability to persevere despite not obtaining immediate results, he has very high standards and usually achieves them, he continues to focus on the future and the goals he wants to reach, he is a sensitive man, aware of other people’s emotions, he has a stable work record and loved his original job but has shown determination and flexibility in being able to find new work, he has a stable mental health history, he has a strong family unit and a high level of commitment to his family.

What these strengths suggest to me is that once he has a direction and knows what to do next, Kevin will be able to follow a plan for quite some time without needing immediate results to keep him focused. He’s shown this in a number of ways in his life, and like everything, it has both helpful and not so helpful aspects! It can mean that he perseveres with inappropriate or unhelpful strategies too – but once he’s got an idea or goal in mind, he doesn’t give up readily.

His sensitivity to others emotions means that he is quite reserved in his own emotional responses, while being careful not to irritate or anger others. This means his relationships are very stable – but he wears the cost of this at times because he can fail to acknowledge his own needs. It also means he works very hard to interpret what other people may be feeling without needing to ask. Although this can be a problem for him, because he can feel responsible for other people’s emotions (because he feels he should be able to absorb his own emotions without burdening others), it also means he can learn to alter his own behaviour, notably pain behaviour, which can be helpful in the long term to reduce disability. It helps to minimise unhelpful communication of pain to others in his life. Given some guidance to identify the inadvertent signals he is currently sending, he will be able to monitor his own pain behaviour and modify it appropriately.

His close family connection provides him both with emotional support and motivation or drive to pursue new avenues for growth. Although as I’ve noted above, this could lead him to feel overly responsible for his family’s feelings and prevent him from acknowledging his own needs and seeking support, it also provides impetus for him to take steps and find ways to obtain new employment. He is prepared to try risky new things in order to maintain his home relationships. It’s like a stable platform from which he can look at new possibilities. Perhaps by encouraging his family members to be included in his pain management, he can strengthen his relationships, and begin to draw strength from them rather than always being the source of strength for others.

Getting a different picture of Kevin now? Rather than seeing him as a person with a whole lot of needs that cause trouble, Kevin looks much more like the competent man he was before his pain developed and started to derail his life.

Something I love about pain management is that the people I work with have all had areas of effectiveness prior to their pain problem. Every person brings their own resources to their situation, although sometimes the ways they’ve been using them in the new situation may not always be as effective in the long-term as they’d like. I think my job is to work with people to help them discover how to build on their strengths, and use them in a flexible and adaptable way.

Bouncing back – resilience

ResearchBlogging.org
After looking at positive coping in my post from yesterday, I hoped to bring an assessment to light – and lo and behold I found one!
This brief assessment differs from other resilience measures in that it looks at recovery, resistance, growth and adaptation rather than simply the resources a person might bring into a stressful situation. Smith and colleagues from the University of New Mexico developed this assessment and tested it on four groups of people – those recovering from cardiac problems, a group of women with fibromyalgia, and as usual, two groups of university students.

What’s nice about this scale is that it contains only six items:
1. I tend to bounce back quickly after hard times
2. I have a hard time making it through stressful events (R)
3. It does not take me long to recover from a stressful event
4. It is hard for me to snap back when something bad happens (R)
5. I usually come through difficult times with little trouble
6. I tend to take a long time to get over set-backs in my life (R)

The (R) refers to reverse scoring.

I don’t want to go into the research design this time around, but cut straight to the results – which showed that the Brief Resilience Scale ‘was positively correlated with the resilience measures, optimism, and purpose in life, and negatively correlated with pessimism and alexithymia. In addition, it was positively correlated with social support and negatively correlated with negative interactions. Finally, it was consistently positively correlated with active coping and positive reframing and negatively correlated with behavioral disengagement, denial, and self-blame.’

It looks like it correlates well with the things I’m keen on identifying in the people I work with. Along with the above associations, the results also ‘consistently negatively correlated with perceived stress, anxiety, depression, negative affect, and physical symptoms. In addition, it was positively correlated with positive affect in three of the four samples and with exercise days per week in the cardiac rehabilitation sample. It was negatively correlated with fatigue in the cardiac sample and negatively correlated with fatigue and pain in the sample of middle-aged women.’

So what I hear you cry! We can find out if people perceive themselves as ‘bounce-back’ people, or not. What of it?
Well, my thoughts are that these are protective features in a person – perhaps this group of people will manage their pain rather more readily than those who show low levels of bouncability (is that a word?!). If we can enhance these attributes – or if we have people who demonstrate a high score on this assessment but are temporarily lacking in things like social support, active coping or optimism – we might be able to provide ‘pain management lite’ to these people, allowing us to focus on helping them grow and make positive changes. In people who don’t demonstrate such resilience, we may need to focus our attention on a much more intensive programme to help them not only access social support, develop active coping or start to become more optimistic, but also help them gain a sense of their own resilience.

I can see a measure like this being used as an outcome measure – instead of focusing exclusively on changes in depression score or disability, we can add in a measure of resilience – and it may well help people develop a sense of their ability to bounce back from other health problems in the future. What I like about it is the brevity, the positive focus and that instead of looking at factors that enhance resilience, it directly measures self perception of resilience. If we add some of the other measures that look at what contributes to resilience, we start to develop a battery of assessment measures that we can use to help enhance our understanding of what works and what can be supported, rather than what needs to be ‘managed’ or are deficits.

If you’ve enjoyed this brief post, come on back tomorrow – there will be more! I post most week days, love comments and usually respond quickly, and I’m keen to expand the areas that you might like to hear about. If you’d like to introduce yourself, feel free to drop me a line via the ‘About’ page – that will send directly to my intray. Have a great day and I hope you come back again.

Smith, B., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back International Journal of Behavioral Medicine, 15 (3), 194-200 DOI: 10.1080/10705500802222972

Accentuate the positive

ResearchBlogging.org
How often do we spend most of our assessment time looking at people’s problems, deficits, functional difficulties? I know that much of my time in assessment involves looking across a range of domains and experiences – and whooops! by the time we come to an end I’ve hardly looked at what this person has continued doing despite their pain and distress. After reading this 2005 paper by Tedeshi and Kilmer I’m ready to re-orient myself and review the structure of my assessment interview to see how I can integrate the resources and strengths that a person brings into the situation.

There are three main areas that Tedeshci and Kilmer identify as useful to explore when looking at the positives of an individual:

Strengths - ‘the measurement of thos eemotional and behavioural skills, competencies and characteristics that create a sense of personal accomplishment; contribute to satisfying relationships with family members … enhance ones ability to deal with adversity and stress; and promote one’s personal, social and academic development’ (Epstien and Sharma (1998).

Resilience‘attributes or characteristics that might include positive temperament,  self efficacy, positive self worth; problem solving skills; internal locus of control’ along with ‘a warm family environment, sound relationships’ and ‘good supports within the community, connections to school and work’ (Tedeschi and Kilmer, 2005).  In other words, things that help people ‘bounce back’ under adversity.

Growth - this area refers to ‘positive changes in individuals that occur as the result of attempts to cope in the aftermath of traumatic life events…become transformed by their struggles with adversity’ (Tedeschi and Kilmer, 2005).

Something I have emphasised in my work with people living wih chronic pain is that everything they have ever done to cope with or manage their situation has both positive and not so positive aspects to it.  We need to remember that people don’t deliberately set out to fail or have negative consequences. Typically the short-term consequences, if not helpful or positive, at least avoid the immediate negative emotional impact of a situation.  It’s the longer-term consequences that often cause the problems!  Something I can readily appreciate is how a person can choose a course of action believing that it is the ‘right’ path, such as resting or over-using medication or avoiding certain movements – it does stop pain! But of course, we know what happens over time…

So in looking at strengths, perhaps some of what we might view as a negative – for example, the ‘boom and bust’ pattern of activity – could in fact be a strength.  The person who does this may well be very good at task persistence, sticking to a quite difficult activity until it’s done, perhaps even have very high standards and values, but simply be misapplying this to the activity, and failing to manage the long term consequences.

I’m sure we can all appreciate how recognising and affirming strengths might help develop rapport, increase the person’s sense of personal competence, and improve ‘motivation’.  It may help move us from trying to ‘fix’ a problem to building a solution or enhancing a characteristic that already exists.

A couple of questions that might help us assess strengths (and I’ve modified these from Tedeschi and Kilmer):

  1. Let’s talk for a while about what you’ve managed to keep doing despite your pain.
  2. Tell me what you’re good at and what makes you proud
  3. How do you keep doing important things when your pain is bad?

Resilience can act as a protective factor when people are exposed to stress, it’s often described in terms of flexibility, and can reflect the interaction between the individual, the family and the community.  Tedeschi and Kilmer suggest that ‘rather than viewing a goal of evaluation as assessing resilience per se, it may be more appropraitely framed as seeking to assess factors associated with positive adjustment, competence in core domains, and healthy outcomes under adversity.’ (Tedeschi and Kilmer, 2005).

In pain management, we’re most often looking at self efficacy for managing pain – something like Mike Nicholas’ Pain Self Efficacy Questionnaire can be helpful to establish ‘what can you still do despite your pain’.  Some other questions based on those suggested in this paper are:

  1. How do you go about doing things when times are challenging?
  2. What do you do to figure out something by yourself?
  3. What do you do when you’re faced with a problem or stressful situation? How do you handle it?
  4. What is getting you through this tough situation?

These questions might highlight areas to draw upon when extending the person’s coping framework – do they have certain people or agencies that help? Do they have a core set of problem solving strategies that could be extended to deal with chronic pain? Do they already have skills they use in a helpful way?

Growth – it’s not often that we hear about how chronic pain can help a person grow and develop. I know I’ve heard about the positives from having depression, and I know I’ve experienced this myself, but I can’t say I’ve heard many people talk about the good things they have experienced or the way they have been transformed by their pain.  However, if we take a good hard look at what can happen as a result of facing tough times, I think it’s clear there are some good things – like knowing you do have strength, like valuing time out and family, like recognising vulnerability and appreciating the ‘little things’ in life.  Some people have told me that by stopping work they’ve lost their sense of self identity as a worker – but gained a sense of being a person within a community or family.

Tedeschi and Kilmer note that people who report positive growth after adversity ‘may not be able to leave all of their distress behind.’  They go on to say ‘many indicate that they are still suffering from the aftermath of trauma.’  There are, however, five domains of possible growth after trauma that can be assessed – improved relationships, new possibilities for one’s life, a greater appreciation for life, a greater sense of personal strength, and spiritual development.  And yes, some of these are areas that people I’ve worked with have said they now appreciate more deeply – and don’t take for granted any more.

I hope this brief tour through areas of positive psychology might tantalise – perhaps we’ll stroll through the sunny side of the street this week.  Let’s accentuate the positive today!

Tedeschi, R., & Kilmer, R. (2005). Assessing Strengths, Resilience, and Growth to Guide Clinical Interventions. Professional Psychology: Research and Practice, 36 (3), 230-237 DOI: 10.1037/0735-7028.36.3.230

Chronic Pain Australia

It’s amazing the networking that can happen over the interweb.  Today I had a message from ‘Cozzie’.  Now you’d have to think, if you’re a Kiwi, that Cozzie is an Ozzie – and you’d be right!

Well, she said she’d read some of my posts and thought they were OK – so I took a look at her site, and blow me down (you have to bring out these sayings when it’s a Kiwi/Ozzie think), she happens to be Ms Coralie Wales, President of the organisation called ‘Chronic Pain Australia’

  Take a look at the website, it’s great! This is an organisation I think we need here in New Zealand.Thanks to the wonders of the internet, at least you can link to it, so here is the link.  Go on, go visit.  And I’ve put a link into my blogroll.   Better than that, if you’re in Australia, get involved.  People with chronic pain live all around us, and they’re just like you and me.  In fact, they could be you and me. 

Bliss – the internet has some wonderful things going for it.