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

2. The Treatment of Pain Disorder Symptoms Through Counseling

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

4. 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!!!!

5. 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

6. 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)

7. 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