January 7th, 2011 admin
Treatment takes many forms and involves a number of different members of the treatment team as well as the social worker. Interventions must be individualised to address the particular needs of individual patients and their families.
Supportive counselling is the mainstay. It may be conducted on an individual basis for the patient or a family member, as a family meeting or as a discussion group involving other patients and families. Supportive counselling aims to facilitate coping and involves listening, allowing emotions to be expressed, answering and informing. Practical assistance such as the provision of aids for daily living, facilitating minor alterations in the home and accessing community resources and services will be beneficial. Every effort should be made to maximise the support, both professional and non-professional, available to families. Assistance with financial and legal matters is often necessary.
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PSYCHOLOGICAL AND PSYCHOSOCIAL ASPECTS OF PAIN CONTROL: SOCIAL PROBLEMSTreatment takes many forms and involves a number of different members of the treatment team as well as the social worker. Interventions must be individualised to address the particular needs of individual patients and their families. Supportive counselling is the mainstay. It may be conducted on an individual basis for the patient or a family member, as a family meeting or as a discussion group involving other patients and families. Supportive counselling aims to facilitate coping and involves listening, allowing emotions to be expressed, answering and informing. Practical assistance such as the provision of aids for daily living, facilitating minor alterations in the home and accessing community resources and services will be beneficial. Every effort should be made to maximise the support, both professional and non-professional, available to families. Assistance with financial and legal matters is often necessary.*81\55\2*
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April 21st, 2009 admin
The purpose of the ACPA is to provide a support system for those suffering from chronic pain. In addition, the ACPA offers training in skills and attitudes that have proven efficacy in helping people to deal with chronic pain.
Members learn to use physician-approved stretching exercises (as used in this book), relaxation techniques, assertiveness training methods, advice on sleeping as normally as possible, nutrition, family involvement and a better understanding of the feelings pain helps to create — all to help the affected person to live more fully.
They learn to recognise limitations and to set realistic short and long-term goals for themselves. ACPA groups do not focus on physical pain, but rather on developing a member’s positive attitude and an enhanced perception of self-control. They seek to exchange the passive role of the patient for that of an independent person whose pain is kept in proper perspective.
The group does not take the place of traditional medical treatment, but works with the medical group to allow members of ACPA to take more responsibility for their own recoveries. Membership is an addition to, not a substitute for, medical and professional services the person with pain may have already pursued.
The organisation publishes a quarterly newsletter, the ACPA Chronicle, produced by group members themselves and twice-monthly meetings are held. The meetings usually last two hours, and ACPA suggests that membership be limited to about ten people. This is because experience has taught ACPA that this allows new members to build trust in each other.
Since much of what is said in the group is personal, trust and comfort are critical; fear of betrayal and censure must be removed.
ACPA supplies for a minimal charge comprehensive manuals for those interested in setting up local chapters. These consist of a Leaders Manual, for those keen enough to take on the leader role, and a members’ manual.’
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April 21st, 2009 admin
In ‘Getting Well Again’2 the Simonton’s give the following outline for reversing some of changes mentioned above. The same principles have a great relevance in the self-management of non-malignant pain.
1. With the diagnoses of a life-threatening illness, the individual gains a new perspective on his, or her, problems. Many of the rules by which an individual lives suddenly seem petty and insignificant in the face of death.
The threat appears to give an individual permission to act in ways that didn’t seem an acceptable option beforehand. Suppressed anger and hostility can now be expressed. Assertive behaviour is now seen as OK. Illness permits the person to say no.
2. The individual makes a decision to alter behaviour, to be a different kind of person. As behaviours change, apparently unresolv-able conflicts may show signs of resolution.
There’s more freedom to act and more resources with which to live. Depression often lifts when repressed feelings are brought into the open, and increased psychological energy is available. The individual makes a decision to become a different kind of person. Cancer serves as a dramatic permission to change.
3. Physical processes in the body respond to the feelings of hope and the renewed desire to live. This phenomenon, not only seen in cancer, creates a reinforcing cycle in harmony with the new mental state.
The renewed hope and desire to live, initiate physical processes that result in improved health. Since mind, body and emotions act as a system, changes in the psychological state result in the physical state changing as well.
This process, of course, has its ups and downs. Even with renewed hope, and a different perception of self and the problem, there are usually difficult times. There may be temporary physical setbacks until the patient again feels confident enough to cope with the situation.
4. The recovered patient is ‘weller than well’. Basically, the same observation applies to those who have actively participated in a recovery from cancer. They have a psychological strength, a positive self-concept, a sense of control over their lives that clearly represents an improved level of psychological development.
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April 21st, 2009 admin
Techniques for hypnotic pain reduction present a number of interesting similarities to familiar psychological defence mechanisms normally used as coping mechanisms. These are amnesia (repression), substitution, denial, displacement and retreat into fantasy. Thus, symptoms may be substituted (pain can become a tingling sensation or ‘painless’pain) or displaced (for example, from the abdomen to the finger). Symptoms may even be denied. To the patient, they simply do not exist! Amnesia can be used to blur or reactivate memories of a previous experience while selective awareness allows patients to divide their attention. For example, the patient may be asked to imagine leaving their painful body behind and taking a rest.
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April 21st, 2009 admin
This includes individual psychotherapy or group psychotherapy. Individual psychotherapy may offer help in changing the way someone feels about his or her pain, or alternatively to employ other supportive measures.
It may also seek to find the cause of the problem. These psychological approaches give both the practitioner and the patient time to explore the patient’s personality and behaviour patterns and also to determine how the patient’s perception of pain affects his or her life. It also helps to define, and measure, the emotional needs of the individual.
Group thorapy Group therapy is a treatment technique which uses the interaction of patients within a group to achieve the treatment goals.
In an in-patient or residential pain clinic, for example, group therapy includes all the interactions among patients. In-patients eat together, exercise together and encourage each other to act in normal ways. They are constantly interacting with one another and testing their new behaviour on new fellow patients and so eventually helping them to better understand how they cope with their pain.
The sharing of experiences and feelings, resulting from such group therapy, helps chronic pain patients to readjust their thinking and to develop new ways of coping with pain.
Such treatments are mainly available from registered psychologists, many of whom work in pain units.
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