Some theory - and how we can put it into practice

Before we start on cognitive behavioural therapy, we need to know what we’re on about - for me in pain management, CBT assumes:

that people are capable of change,
can accept self responsibility for their actions,
that what we think and believe about a situation can affect our emotions and responses, and
that we can implement a whole [...]

Return to work and chronic pain

Again this post is a bit of a reflective one, but also refers to the literature a wee bit too…
I’ve posted before about the importance of support in the workplace for people returning to work…and of the value of work to people living with chronic pain.
How about some of the wider issues that may [...]

Values and goals

I can’t recall exactly where I heard it, but values are like a compass - they provide general guidance as to what is important in life, while goals are the map of how we are going to get there. I’ve been mulling over this as I worked with some people over the past couple [...]

Evaluation of a CBT informed pain management programme

A few posts ago I discussed the challenges of transferring research into practice, and discussed the examples of laterality training and graded exposure for CRPS. It’s difficult to know exactly what results to expect when moving from carefully selected participants to all-comers, and from highly detailed and prescribed protocols to more general principles and [...]

A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work-related activities

DOI:10.1016/j.ejpain.2007.11.001
The complex question of whether to integrate experimental therapeutic interventions into daily clinical practice is one that has caught many therapists out. A case in point is the use of laterality and visualised movements for CRPS where, in one clinic, it was found that of the 10 participants recruited, only 4 had actually adhered [...]

Advances in the science of acupuncture

Acupuncture has been used in China for thousands of years - it’s one of the first ‘alternative’ treatments requested by patients experiencing persistent pain, and one that has been receiving increasing attention from the scientific community as neurobiological research progresses.
This paper by Wang, Kain & White provides an overview of the state of [...]

Clear communication - an activity to encourage active listening

People who experience pain can have trouble saying what they want to happen - and difficulty hearing what other people really have to say. OK, I agree it’s a problem for us all - but

pain interferes with the capacity to attend to and process information, and
people with pain are often engaged in systems such [...]

Are you afraid to push your patients?

We have all heard about fear avoidance, or pain-related anxiety and avoidance in patients (Vlaeyen & Linton, 2000). This model of pain disability has become increasingly prominent over the past 10 years and research has demonstrated its effectiveness in predicting those who will develop long-standing disability, as well as providing amodel for treatment approaches [...]

Outcomes and effectiveness and other wonderful things…

The IASP publishes a huge range of books and other resources, but one of the ones I really like getting is their Clinical Updates. Each month a brief update on an area of pain is published, and this month discusses an issue really close to my heart: outcomes, or ‘will this treatment help?’
This [...]

Ethics and therapy choices

I was having a discussion yesterday with a colleague who has recently started working in another area of health, away from pain management.  He was talking about the different philosophy that exists in this new area, and the change of practice that he was learning to deal with, and it made me stop to think [...]