Behavioral Therapies

 

Psychological Therapy
Pain can mean different things to the person experiencing it and to the doctor being consulted. Pain tends to interrupt a person’s thoughts and actions and to dominate their attention.
Many patients’ have insufficient or unhelpful information about what the pain is, and/or perceive it as a serious threat, and are unable to cope with it.
Patients may feel that their doctor does not understand their pain, or has not appreciated their problems, and are less likely to accept and adhere to treatment if they feel is not helpful.
Often patients’ attempts to cope with their pain will be undermined by concerns that they may be making their condition and therefore their pain worse.
Psychological techniques in chronic pain
 
Biofeedback
Diverting or competing stimuli can improve pain levels during the biofeedback procedure and during intervals afterwards.
The basic pain biofeedback system is a demonstration to the patient, of the effect of internal emotional states on global physiological functions. Example: skin resistance, pulse, respiratory pattern, EEG; and focal processes, that is, electromyography [EMG] activity in regions of pain.
Studies of several conditions have demonstrated the positive effects of this approach, usually combined with other physical therapy modalities.
Virtual Reality Biofeedback in Chronic Pain and Psychiatry.
 
Cognitive Behavioural Therapy
Cognitive behavioural approaches aim to improve the way that an individual manages and copes with their pain.
The approach is very much related to problem solving and returning control to the sufferer.
Many patients state that the pain rules their lives and cannot see how this can change without a medical cure. However, with appropriate instruction in a range of pacing techniques, cognitive therapy to help identify negative thinking patterns and the development of effective challenges, stretching and exercising to improve physical function, careful planning of tasks and daily activities, and the judicious use of relaxation training, many people find the treatment enables them to take back control of their lives.
Cognitive Behavioural Therapy.
 
Counselling (Professional Confidential Support)
Our Counselling Service is tailored to meet the needs of each patient.
The service is run by experienced and qualified Counsellors specialising in individual counselling for patients with painful conditions.
What can Counselling offer?
  • Finding new ways to look at long-term pain problems
  • Coping with irreversible or chronic medical conditions
  • Dealing with the impact of illness on the entire family
  • Assessing situations and finding appropriate solutions

 

Coping Strategies
Professionals who treat chronic back pain recognize it is not merely a sensation, but is strongly influenced by the ways in which the brain processes pain signals.
There are a number of techniques including relaxation training, hypnosis, biofeedback and guided imagery. Techniques for coping with long-term pain make use of four types of skills:
  1. Deep Muscle Relaxation.
  2. Distraction- moving your attention away from pain signals.
  3. Imagery - visual, sound or other pictures and thoughts that are pleasant and relaxing to you.
  4. Dissociation - the ability to separate normally connected mental processes, leading to feelings of detachment and distance from the pain.
Effective coping strategies for chronic back pain.
 
Functional Restoration Programmes
Functional Restoration Programmes are run on an outpatient basis and aim to teach the pain sufferer a number techniques and skills to manage their pain more effectively.
Functional Restoration Programmes are delivered using a multi-disciplinary approach, including Doctors, Nurses, Physiotherapists and Occupational Therapy Practitioners.
This also includes a large element of passive and active rehabilitation including exercises and aerobic conditioning.
 
Pain Management Programmes (PMP)
A Pain Management Programme (PMP) is a psychologically-based rehabilitative treatment for people with chronic pain which remains unresolved by other treatments currently available.
It is delivered in a group setting by an interdisciplinary team of experienced health care professionals working closely with patients.
The aim of PMPs is to reduce the disability and distress caused by persistent pain by teaching physical, psychological and practical techniques to improve quality of life.
It differs from other treatments provided in Pain Clinics in that pain relief is not the primary goal, although improvements in pain following participation in a Pain Management Programme have been demonstrated.
 
Relaxation Techniques
Relaxation techniques are helpful for coping with stress and chronic pain. Relaxation techniques entail refocusing attention, increasing body awareness and gentle exercises.
Relaxation Techniques.
Relaxation
Anxiety, tension and stress can make the cycle of pain worse. Relaxation techniques can help to break this cycle.
Techniques include deep breathing exercises, muscle relaxation, visualisation and the ‘stress ball’. These techniques can be very powerful and give back control to the patient.
They all take less than 5 minutes to perform and can be repeated as often as required.
Pacing
Patients with long term pain conditions often have good and bad days. When it’s bad, normal daily activities such as shopping or meeting friends can become obstacles.
Pacing aims to break up any activity into smaller, more manageable steps. These allow patients to reach their goals using reasonable bite-sized steps to get there.
Goal Setting
We encourage patients to set realistic goals on their journey of rehabilitation. Such goals are often set in conjunction with our Clinicians and Physiotherapists.
Exersize
We encourage patients to exercise gently as part of their rehabilitation.
Exercise programmes are initiated by our physiotherapists and includes gentle mobilisation of the affected body part, aerobic stamina and core stability work.
Coping with flare-ups
From time to time, patients experience periods of increased pain or flare-ups. Ways to cope with these include: recognition, take medication regularly, re-set goals as appropriate, think positively, use relaxation and breathing exercises, and seek medical help if persistent.
Better Sleep
Patients with pain often have disrupted sleep. There are a number of simple steps to improving ‘sleep hygiene’.
Attention to the sleep environment:
  • Black-out curtains
  • Removal of extraneous noise
  • Relaxation techniques before bedtime
  • Eliminating alcohol, caffeine and stimulant intake 4 hours before bed.
These are often more successful than the use of medication to aid sleep.
Managing Stress
Stress is a normal part of everyday life. Short term stress can help us complete our tasks and activities, but when this becomes chronic, it can be detrimental to health.
Pain is associated with increased anxiety, depression and stress. The first step is to identify those situations that exacerbate stress and developing strategies to manage these.
Medication Management
Understanding the aims and roles of medication is the first step to taking control. When and how to use them optimally and when to use other techniques is essential.