Counseling Tools Life Hacks for Chronic Pain Management



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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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