Robert Rosenbaum – 2-Day Chronic Pain Course: Behavioral Treatment and Assessment

Outline

Impact of Chronic Pain on Mental Health

Primary Prevention

• The best treatment is prevention
• Early detection and early intervention

Pain Prevalence and Impact

• Incidence and prevalence: most common types
• Societal costs
• Impact on client mental health and quality of life

Sociodemographic factors
The Biology of Pain

• What is pain?
  • Physical, emotional, psychological, and environmental factors
  • Pain intensity vs pain distress
• Types of Pain
  • Nociceptive and neuropathic
  • Effect of location
  • Etiology, temporal course, sensation
  • Inflammation, cancer, Ischemic
  • Acute vs chronic pain
• Pain transmission and modulation
• Neurochemicals of pain
• Pain, Brain, Strain
  • Central sensitization
  • The role of attention
• Pain: Beyond Basic Biology
  • Biopsychosocial model
  • Vicious circles of maladaptive coping strategies
  • Psychological and emotional aspects of pain
  • Pain’s effect on the sense of self
  • Countering pain myths

Assessment, Interventions, and Management

Pain Treatment Options

• Medications and medical procedures
• Introduction to analgesics
• Opioids – Myths and Facts

The opioid epidemic

• Opioid efficacy, risks
• Tolerance vs. addiction
• Risk of addiction and abuse

Assessment

• Basic guidelines
• The interview
• Psychometric instruments
• Pain vs. distress

Behavioral Treatment

• Technique vs. relationship
• Mindfulness and other meditations
  • The hype and the reality
  • Focuses and open awareness
  • Breathing techniques: four methods
• Comfort strategies: You Are Bigger than the Pain
  • Awareness
  • Importance of early detection
  • Concretizing with imagery and names
• Re-Focus
  • Widening and narrowing attention
  • Going distal; going to the center
  • Imagery and self-hypnosis
• Re-thinking
  • CBT for catastrophizing
  • Separate pain from distress
  • Deal with flares
• Additional behavioral treatment tools
  • Pacing
  • Gentle movement
  • The importance of face, hands, feet
  • Acupressure self-massage
  • Qigong for pain
  • Sleep and rest
• Enjoy
  • Cultivating positives
  • Antidotes for difficult emotions
  • Increasing emotional granularity
• Relate
  • Foster positive relationships
  • Deal with difficult relationships

Differential treatment considerations
Outcomes of integrative interventions
Research limitations and risks of psychotherapeutic approaches