Treatment of Clients Experiencing Pain Disorders A Collaborative Approach to Care June 2, 2018 * Tex-CHIP Training Series

The Treatment of Pain Disorder Symptoms Through Counseling

Understanding Provider Role in Treating Pain Disorders Evaluator/Consultant Data collector Educator Facilitator Motivator Reinforcer Outcomes Analyst

Considerations when Interacting with Clients Patient is often frustrated/suspicious of healthcare providers. -Angry/Unmotivated due to lack of answers, “They treat me like I am crazy!” “I have tried everything!” -Remember- They are hurting, often feel misunderstood. Critical to balance empathy and understanding with being directive and authoritative. Co-occurring disorders prevalent with Chronic Pain Patients Patients with chronic pain may be highly focused on medication options. -Emphasize benefits of self managed care techniques. Focus on what patient CAN control. Redirect, redirect, redirect!!!! Stick with it!!!!

Our Treatment Plan Healthcare Domain: Behavioral Health Provider: LPC Objective: Provide alleviation of presenting chronic pain symptoms as indicated by client report of: (a) “Unbearable back pain” d/t a fall (b) Depressive Symptoms (c) Social/Familial Discord (d)  Sleep Difficulties   Goals: a.) Reduce the impact pain has on daily life. b) Maximize daily function and improve quality of life. c) Decrease negative thinking and painful emotions (e.g., anger, anxiety, & depression) d.) Learn skills for coping better with pain. Interventions: a)  CBT-CP b)  Cognitive Coping Techniques  c) Relaxation Training d.) Sleep Hygiene Education

Measuring Outcomes/ Success Demographics Interview/Self Report Pain Numeric Rating Scale (Pain NRS) Subjective Units of Distress Scale (SUDS) Pain Catastrophizing Scale (PCS) West-Haven Yale Multidimensional Pain Inventory - Interference (WHYMPI/MPI-INT) Beck Depression Inventory - Second Edition (BDI-II) Patient Health Questionnaire (PHQ-9) World Health Organization Quality of Life – Brief (WHOQOL- BREF) Working Alliance Inventory – Short Revised (WAI-SR)

Communication Needed From Other Providers Referral from PCP PCP ‘Exercise Clearance’ Collaboration of Treatment Planning Nutrition Education Social Work/ Case Management exploring resources Pharmacist and Psychiatrist